| NPI | 1386833184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN EDME MCDONALD Dentist 928-783-8481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AZ 5622) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2007-11-19 |