| Organization Name: | CORSICANA CHILDRENS DENTAL ASSOCIATES |
| NPI Number: | 1063789550 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALLEN I PEARSON (OWNER) |
| Mailing Address: | 842 W 7th Ave Suite D Corsicana |
| State: | TX US |
| Postal Code: | 751106318 |
| Phone Number: | 9038475437 |
| Fax Number: | 9724991040 |
| NPI Enumeration Date: | 11/28/2011 |
| NPI Last Update Date: | 12/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | 21036 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| 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. |