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General NPI Number Information
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NPI Number | 1043606171
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Entity Type | Organization
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Legal Business Name | HEALTHY KIDS KAMPUS, PC
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 910 W IRVINGTON RD SUITE 170A
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City | TUCSON
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State | AZ
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Zip | 85714-2458
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Country | US
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Telephone | 520-975-4927
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Fax |
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Provider Business Mailing Address
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Address Line | 4723 E CAMP LOWELL DR
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City | TUCSON
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State | AZ
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Zip | 85712-1256
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Country | US
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Telephone | 520-975-4927
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ANTHONY CHARLES CAPUTO
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Credential | DDS, MA
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Telephone | 520-975-4927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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