| NPI | 1669774964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN L DIQUATTRO Owner 928-474-5231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ d7558) |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2010-11-19 |