| NPI | 1932518404 |
|---|---|
| Doing Business As | PRESCOTT VALLEY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DARREN L LINE Owner 928-759-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2022-06-14 |