NPI | 1225150261 |
---|---|
Former Legal Business Name | ACOSTA SMILE, LTD |
Entity Type | Organization |
Authorized Contact | DAVID DEJESUS ACOSTA General Dentist 520-889-6622 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D5235) |
Enumeration Date | 2007-04-03 |
Last Update Date | 2020-08-22 |