| NPI | 1225274087 |
|---|---|
| Other Name | KIDS LITTLE SMILES DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHARLES J. LUCERO General Dentist 928-718-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D4688) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D5580) |
| 1223G0001X Dentist, General Practice (Licence: AZ D7582) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D5432) | |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2008-12-29 |