Organization Name: | LITTLEGRINS , P.L.L.C |
NPI Number: | 1033473103 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH DREW GALLEMORE (OWNER) |
Mailing Address: | 2179 W 24th St Ste B Yuma |
State: | AZ US |
Postal Code: | 853646163 |
Phone Number: | 9287824708 |
Fax Number: | 9287822212 |
NPI Enumeration Date: | 07/03/2012 |
NPI Last Update Date: | 07/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 4390 |
Healthcare Provider Taxonomy: (Secondary) | Y |
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. |