| NPI | 1548394976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LEE MAST President 928-774-2997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 1905) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |