| NPI | 1477821460 |
|---|---|
| Doing Business As | MESA MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CARL C FAIRCHILD Owner Doctor 480-926-2350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2011-12-06 |