| NPI | 1639339930 |
|---|---|
| Doing Business As | ACADEMY KIDS DENTAL VISION AND ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | SAMANTHA B LEBLANC Credentialing Specialist 719-323-2372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2021-04-29 |