| NPI | 1548737208 | 
|---|---|
| Doing Business As | VILLAGE DENTAL CARE | 
| Entity Type | Organization | 
| Authorized Contact | BRADLEY J HENKENIUS Owner/President 928-774-0181  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental | 
| Enumeration Date | 2018-10-30 | 
| Last Update Date | 2018-10-30 |