Organization
COTTONWOOD MODERN DENTISTRY, LLP
Active
Other names
Cottonwood Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL C FAIRCHILD DDS (OWNER DOCTOR)
(928) 472-8000
Entity
Organization
Contact information
Practice address
1061 S HIGHWAY 260, COTTONWOOD, AZ 86326-4624
(928) 472-8000
(928) 472-8001
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/24/2013
Last updated
08/25/2022
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