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Organization
SEASONS SAGE
Active
Organization
SEASONS SAGE
Active
Other names
Bradshaw Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID FRAUSTO DDS (OWNER)
(928) 237-1305
Entity
Organization
Contact information
Practice address
1260 S STATE ROUTE 89 STE G, CHINO VALLEY, AZ 86323-6624
(928) 237-1305
(928) 237-3038
Mailing address
1260 S STATE ROUTE 89 STE G, CHINO VALLEY, AZ 86323-6624
(928) 237-1305
(928) 237-3038
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D5639
AZ
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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