| NPI | 1700489903 |
|---|---|
| Doing Business As | ACADEMY KIDS DENTAL, VISION AND ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | SHAUN URBANOZO Credentialing Manager 719-323-2362 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2020-11-19 |