Provider First Line Business Practice Location Address:
JCT OF RTE NR-21 & HWY 160
Provider Second Line Business Practice Location Address:
TONALEA CHAPTER - DENTAL
Provider Business Practice Location Address City Name:
TONALEA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-283-2501
Provider Business Practice Location Address Fax Number:
928-283-2677
Provider Enumeration Date:
10/16/2012