| NPI | 1801332093 | 
|---|---|
| Doing Business As | TOOTH CLUB FOR KIDS | 
| Entity Type | Organization | 
| Authorized Contact | ALAN MCKAY GARRETT Owner/Dentist 208-670-2914 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D008806) | 
| Enumeration Date | 2017-01-11 | 
| Last Update Date | 2017-01-11 |