| NPI | 1992935357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R MIKE SHIRTCLIFF President/CEO/Dental Director 866-268-9616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2011-09-23 |