NPI | 1861855884 |
---|---|
Doing Business As | BRADSHAW FAMILY DENTAL |
Entity Type | Organization |
Authorized Contact | DAVID FRAUSTO Owner 928-775-9495 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization |
Enumeration Date | 2016-03-29 |
Last Update Date | 2016-03-29 |