Organization Name: | CHILDREN'S DENTAL SPECIALTY GROUP LLC |
NPI Number: | 1003224619 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MIRURIEL MENDOZA (OFFICE MANAGER) |
Mailing Address: | 7600 E Camelback Rd Suite 8 Scottsdale |
State: | AZ US |
Postal Code: | 852512106 |
Phone Number: | 6024569064 |
Fax Number: | |
NPI Enumeration Date: | 07/27/2014 |
NPI Last Update Date: | 07/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | D008464 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
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. |