| NPI | 1457422669 |
|---|---|
| Doing Business As | COCHISE CHILDREN'S DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | LARRY DEAN BLOOM President 520-458-1835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: AZ D3807) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2008-03-21 |