| NPI | 1568795847 |
|---|---|
| Doing Business As | ACADEMY KIDS DENTAL AND ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | SHAUN URBANOZO Credentialing Manager 719-323-2362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2020-11-18 |