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NPI Code Detail

MEDICARE: KIDS TOOTH TEAM

MEDICARE: KIDS TOOTH TEAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry

General Provider Information

NPI Number : 1003432238
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIDS TOOTH TEAM
Provider Business Mailing Address
First Line : 1245 MAIN ST STE 300
Second Line :
City : BUDA
State : TX
Zip : 78610-2269
Country : US
Telephone Number : 512-523-4774
Fax Number :
Provider Business Practice Location Address
First Line : 1245 MAIN ST STE 300
Second Line :
City : BUDA
State : TX
Zip : 78610-2269
Country : US
Telephone Number : 512-523-4774
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : DR. ALEXANDRA BARTON OTTO
Credential : DDS
Telephone Number : 239-293-0387
Provider Enumeration Date : 06/23/2020
Last Update Date : 02/17/2026

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Directions to “KIDS TOOTH TEAM ” Practice Location

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