| NPI | 1629141650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E. CRUM President 520-745-5051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ 1458) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-08-22 |