| NPI | 1669360160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN HELD Member 928-282-7871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-06-25 |