NPI | 1396095816 |
---|---|
Entity Type | Organization |
Authorized Contact | BRADLEY ROBERTS Owner 928-726-6023 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D04964) |
Enumeration Date | 2012-09-12 |
Last Update Date | 2022-08-22 |