| Organization Name: | THE KID'S DENTIST, PC |
| NPI Number: | 1063871564 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRISTOPHER A ROZHON (DOCTOR/PRESIDENT) |
| Mailing Address: | 7282 Oswego Rd Liverpool |
| State: | NY US |
| Postal Code: | 130903719 |
| Phone Number: | 3154516260 |
| Fax Number: | 3154511022 |
| NPI Enumeration Date: | 02/12/2016 |
| NPI Last Update Date: | 02/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |