| NPI | 1710001797 |
|---|---|
| Doing Business As | MICHAEL KILLEBREW |
| Entity Type | Organization |
| Authorized Contact | MICHAEL J KILLEBREW President 520-401-4191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AZ 2339) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2008-03-04 |