NPI | 1952036626 |
---|---|
Doing Business As | AFTON PEDIATRIC DENTISTRY |
Entity Type | Organization |
Authorized Contact | LUCENDA HARRIS Credentialing And Contracting Coor 980-729-5200 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2022-07-18 |
Last Update Date | 2022-07-18 |