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General NPI Number Information
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NPI Number | 1396636163
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Entity Type | Organization
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Legal Business Name | DENTAL KIDZ PEDIATRIC DENTISTRY LLC
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 475 MORRIS AVE STE B
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-1063
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Country | US
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Telephone | 973-639-1000
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Fax | 973-639-1006
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Provider Business Mailing Address
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Address Line | 475 MORRIS AVE STE B
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-1063
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Country | US
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Telephone | 973-639-1000
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Fax | 973-639-1006
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Authorized Official
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Title or Position | CEO
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Name | CHRISTOPHER HARVELL
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Credential |
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Telephone | 212-518-7000
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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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