| 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 |