NPI | 1740915248 |
---|---|
Doing Business As | SOUTHERN ARIZONA PERIODONTICS - KNIGHT DRIVE |
Entity Type | Organization |
Authorized Contact | COURTNEY R MONTEITH Credentialing Coordinator 217-540-8306 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223P0300X Dentist, Periodontics |
Enumeration Date | 2022-07-19 |
Last Update Date | 2022-09-30 |