| NPI | 1881893584 |
|---|---|
| Doing Business As | ANASAZI FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | JOSEPH ROBERT MIKULICZ Owner 480-821-8295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: AZ 4519) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2007-07-12 |