| NPI | 1447399233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN L. CULLEN President 928-329-9565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ AZ4111) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |