| NPI | 1417633348 |
|---|---|
| Doing Business As | PBJ KIDS DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | PHILIPPE B BAUTISTA Owner 502-744-5442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-12-06 |