| NPI | 1578901351 |
|---|---|
| Doing Business As | KIDS CARE DENTAL & ORTHODONTICS - GREENBACK |
| Entity Type | Organization |
| Authorized Contact | DEREK BOYES COO 916-570-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2023-02-09 |