| NPI | 1861908857 |
|---|---|
| Doing Business As | JENNINGS & LARSON FAMILY DENTISTRY- FORT MOHAVE |
| Entity Type | Organization |
| Authorized Contact | THADD JENNINGS Member 928-201-5588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2017-12-28 |