| NPI | 1760773907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE LYNN COOK Doctor 928-855-7700 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: AZ AZ1687) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-04-21 |