| NPI | 1700148004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES A DAVIS Owner President 520-326-8516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ 1881) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2012-06-12 |