| NPI | 1760536957 |
|---|---|
| Doing Business As | BULLHEADCITYDENTIST.COM |
| Entity Type | Organization |
| Authorized Contact | CARMEN WOODS Ins Cood 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2014-02-04 |