Organization
DEBONAIR INK
Active
Other names
Aesthetic Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORA KAY MOSHOS RDH (PRESIDENT)
(928) 774-1170
Entity
Organization
Contact information
Practice address
1415 N BEAVER ST, FLAGSTAFF, AZ 86001-1401
(928) 774-1170
(928) 774-1171
Mailing address
1415 N BEAVER ST, FLAGSTAFF, AZ 86001-1401
(928) 774-1170
(928) 774-1171
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/25/2010
Last updated
09/08/2010
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