| NPI | 1962966556 |
|---|---|
| Doing Business As | WILMINGTON KIDS DENTIST |
| Entity Type | Organization |
| Authorized Contact | BRIDGET SHIELDS Credentialing Manager 623-282-9959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2019-01-28 |