Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | D7784 | AZ |
NPI | 1043452030 |
---|---|
Provider Name | David W Ho |
First Address | Flagstaff, AZ 86001-3266 |
Second Address | Flagstaff, AZ 86001-3266 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2009 |
Last Update Date | 23/08/2011 |