| NPI | 1760935332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE SPALDING KIMBALL Owner/Dentist 928-718-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1200X Clinic/Center Sleep Disorder Diagnostic (Licence: AZ 4670) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2016-07-29 |