| NPI | 1861722563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME C CUTLER Owner 928-775-7433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ 6772) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ 6407) |
| 122300000X Dentist (Licence: AZ 6207) | |
| 122300000X Dentist (Licence: AZ 5708) | |
| Enumeration Date | 2010-01-04 |
| Last Update Date | 2010-01-04 |