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General NPI Number Information
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NPI Number | 1134237241
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Entity Type | Organization
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Legal Business Name | SMALL WORLD CHILDRENS DENTISTRY SC
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 17585 W NORTH AVE SUITE 230
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City | BROOKFIELD
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State | WI
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Zip | 53045-4365
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Country | US
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Telephone | 262-780-9996
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Fax |
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Provider Business Mailing Address
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Address Line | 17585 W NORTH AVE SUITE 230
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City | BROOKFIELD
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State | WI
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Zip | 53045-4365
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Country | US
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Telephone | 262-780-9996
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. RICARDO E ARAUJO
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Credential | DDS
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Telephone | 262-780-9996
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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 | 4577
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License Number State | WI
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