| NPI | 1245411388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH M BULL Owner/President 928-348-9181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: AZ 4199) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2007-11-16 |