| NPI | 1699260984 |
|---|---|
| Other Name | KIDS DENTISTREE OF IN, LLC |
| Entity Type | Organization |
| Authorized Contact | STEPHEN JAMES CFO 502-254-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-06-28 |