| NPI | 1619746765 |
|---|---|
| Doing Business As | PRESCOTT VALLEY DENTISTRY 4 KIDS |
| Entity Type | Organization |
| Authorized Contact | TERESA ZWICKY Credentialing Manager 480-866-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-12-29 |
| Last Update Date | 2023-12-29 |