| NPI | 1528250990 |
|---|---|
| Doing Business As | KIDS DENTAL PLACE |
| Former Legal Business Name | JACK BAYRAMYAN DENTAL CORP |
| Entity Type | Organization |
| Authorized Contact | SHAUN URBANOZO Credentialing Manager 719-323-2362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 51044) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2023-07-03 |