| NPI | 1942672118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY C BLAIR Dentist/Member 928-634-8567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D4038) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2015-10-27 |