| NPI | 1649856246 |
|---|---|
| Doing Business As | CATALINA FOOTHILLS FAMILY DENTAL |
| Other Name | MARK A LARSEN |
| Other Name | JONATHAN S. ICELY |
| Entity Type | Organization |
| Authorized Contact | LYNNE K MILLER Office Manager 520-891-0817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2021-03-23 |