| NPI | 1033250147 |
|---|---|
| Doing Business As | A TOOTH DOCTOR FOR KIDS- PCC |
| Entity Type | Organization |
| Authorized Contact | JEFFREY TODD ERICKSON President 480-655-8687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-08-22 |