| NPI | 1427482165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADA E CARLOS Accts Receivable Supervisor 928-373-6181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2024-06-05 |