Organization Name: | CALIFORNIA KIDDS PEDIATRIC DENTISTRY |
NPI Number: | 1003102443 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEFFREY B EVANS (OWNER/PARTNER) |
Mailing Address: | 7525 N. Cedar Ave #105 Fresno |
State: | CA US |
Postal Code: | 93720 |
Phone Number: | 5594396600 |
Fax Number: | 5594395400 |
NPI Enumeration Date: | 06/23/2011 |
NPI Last Update Date: | 06/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 60083 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |