| NPI | 1629701578 |
|---|---|
| Doing Business As | SOUTHERN ARIZONA PERIODONTICS - COOL DRIVE |
| Entity Type | Organization |
| Authorized Contact | COURTNEY R MONTEITH Credential Coordinator 217-540-8306 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2022-09-30 |