| NPI | 1013681741 |
|---|---|
| Doing Business As | MOUNTAIN VALLEY KIDS DENTAL |
| Entity Type | Organization |
| Authorized Contact | THOMAS BLAKE HIGGINS Owner 970-390-4662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2021-09-17 |