NPI | 1639990351 |
---|---|
Doing Business As | CHILDREN'S DENTAL SPECIALIST & ADULT DENTISTRY PA |
Entity Type | Organization |
Authorized Contact | JENNY GARCIA-ROCHA Sr Credentialing Team Lead 972-869-3789 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2024-10-24 |
Last Update Date | 2024-10-24 |