| NPI | 1912350364 |
|---|---|
| Doing Business As | KIDS DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | WILEY M ELICK President 559-582-0238 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 21245) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2016-07-21 |