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 |