| NPI | 1295163558 |
|---|---|
| Doing Business As | COTTONWOOD MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CARL C FAIRCHILD Owner Doctor 928-472-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2022-08-25 |