NPI | 1104264985 |
---|---|
Doing Business As | KIDS CARE DENTAL & ORTHODONTICS - STOCKTON |
Entity Type | Organization |
Authorized Contact | DEREK BOYES COO 916-570-1500 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Additional Taxonomies | 122300000X Dentist |
1223S0112X Dentist, Oral and Maxillofacial Surgery | |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
Enumeration Date | 2013-06-13 |
Last Update Date | 2023-02-09 |