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General NPI Number Information
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NPI Number | 1598113953
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Entity Type | Organization
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Legal Business Name | KIDS DENTAL WORKS
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Dates
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Enumeration Date | 05/26/2016
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Last Update Date | 05/26/2016
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Provider Practice Location Address
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Address Line | 1180 SETON PKWY SUITE 425
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City | KYLE
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State | TX
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Zip | 78640-6178
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Country | US
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Telephone | 512-504-3637
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Fax |
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Provider Business Mailing Address
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Address Line | 1180 SETON PKWY SUITE 425
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City | KYLE
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State | TX
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Zip | 78640-6178
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Country | US
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Telephone | 512-504-3637
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SYLVIA CONECHE
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Credential |
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Telephone | 512-259-2331
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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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