| NPI | 1265836043 |
|---|---|
| Doing Business As | ACADEMY KIDS DENTAL AND VISION |
| Entity Type | Organization |
| Authorized Contact | SAMANTHA B LEBLANC Credentialing Specialist 719-323-2372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WP0200X Optometrist, Pediatrics |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2021-11-15 |