| NPI | 1972749703 |
|---|---|
| Doing Business As | A TOOTH DOCTOR FOR KIDS |
| Entity Type | Organization |
| Authorized Contact | EMERICO GOMEZ Owner 602-400-3542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 12300000X) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 123G0001X) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 1223P0221X) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 1223X0400X) | |
| 126800000X Dental Assistant (Licence: TX 126800000X) | |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2008-12-29 |