NPI | 1215281688 |
---|---|
Doing Business As | FIESTA KIDTASTICS |
Entity Type | Organization |
Authorized Contact | JAIME JOHNSON Controller 480-648-4037 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2012-11-06 |
Last Update Date | 2013-12-06 |