| NPI | 1518002146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK R. OLIVAS Dentist 928-774-4030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D4850) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2008-03-06 |