| NPI | 1245489228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK R. OLIVAS Owner/Dentist 928-774-4030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 4850) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 7153) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2008-09-15 |