| NPI | 1811551690 |
|---|---|
| Doing Business As | MYKIDSDDS |
| Entity Type | Organization |
| Authorized Contact | SHAWNA RIDDELL Practice Administrator 214-696-3082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2019-04-26 |