| NPI | 1255986279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE CERVANTES SMALLS Insurance COO Rdinator 928-317-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2019-08-06 |