NPI | 1366198921 |
---|---|
Doing Business As | SPROUT DENTISTRY FOR KIDS |
Entity Type | Organization |
Authorized Contact | JUSTIN N CHAN Pediatric Dentist/Partner 469-301-3212 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
Enumeration Date | 2022-02-23 |
Last Update Date | 2024-06-07 |