# TOOTH B.U.D.D.S., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750811584
- **Authorized official:** MRS. MIQUEL MCRAE RDH (CHAIRMAN/PROGRAM ADMINISTRATOR)
- **Authorized official phone:** (928) 965-1534

## Contact information

- **Practice address:** 168 S. 900 W., PIMA, AZ 85543
- **Practice address phone:** (928) 965-1534
- **Mailing address:** PO BOX 937, PIMA, AZ 85543-0937
- **Mailing address phone:** (928) 965-1534

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 124Q00000X | Dental Hygienist | — | NULL | Yes |
| 124Q00000X | Dental Hygienist | — | — | Yes |

## Other

- **Enumeration date:** 06/14/2017
- **Last updated:** 06/14/2017