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General NPI Number Information
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NPI Number | 1972823888
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Entity Type | Organization
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Legal Business Name | CARE FOR KIDS OF ARIZONA, LLC
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 3301 E THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85018-7302
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Country | US
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Telephone | 602-956-4411
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Fax | 602-956-8877
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Provider Business Mailing Address
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Address Line | 2330 N ALMA SCHOOL RD STE 100
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City | CHANDLER
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State | AZ
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Zip | 85224-2490
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Country | US
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Telephone | 480-388-3222
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Fax | 480-776-6810
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Authorized Official
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Title or Position | LEAD DOCTOR
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Name | MR. MICHAEL HULL
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Credential | DDS
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Telephone | 623-245-8461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | F316
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License Number State | AZ
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