| NPI | 1811171226 |
|---|---|
| Doing Business As | ACACIA FAMILY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | GORDON KENT ROEDIGER President/Owner 520-795-3773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ 2385) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2007-12-20 |