| NPI | 1710110937 |
|---|---|
| Other Name | INNOVATION DENTAL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL C HAYMORE Member 520-297-2514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 7808) |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2009-09-03 |