| NPI | 1962850073 |
|---|---|
| Doing Business As | LAVEEN KID'S DENTIST AND ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | ERIC E ELLIS Owner Doctor 602-883-8649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-06-01 |