| NPI | 1134694698 | 
|---|---|
| Doing Business As | THE KIDS DENTAL OFFICE OF PHOENIX AND ORTHODONTICS | 
| Entity Type | Organization | 
| Authorized Contact | BEN J HIMMELSTEIN Chief Legal Officer 602-903-4849  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry | 
| Additional Taxonomies | 122300000X Dentist | 
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2018-10-10 | 
| Last Update Date | 2022-03-08 |