NPI | 1811275670 |
---|---|
Doing Business As | KIDS DENTAL PLACE |
Former Legal Business Name | JACK BAYRAMYAN DENTAL CORP |
Doing Business As | KIDS AND FAMILY DENTAL PLACE |
Entity Type | Organization |
Authorized Contact | SHAUN URBANOZO Credentialing Manager 719-323-2362 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 51044) |
Enumeration Date | 2011-07-28 |
Last Update Date | 2023-07-03 |