| NPI | 1700103538 |
|---|---|
| Doing Business As | FOUNTAINS FAMILY DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | ERIC L KERBS Managing Member 480-766-8486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ 6458) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 6458) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2010-05-04 |