| Organization Name: | A TO Z CHILDREN'S DENTAL CLINIC, LLC |
| NPI Number: | 1275738668 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARCELLUS GLADNEY (PRESIDENT) |
| Mailing Address: | 805 E High St Grants |
| State: | NM US |
| Postal Code: | 870202448 |
| Phone Number: | 5058761065 |
| Fax Number: | |
| NPI Enumeration Date: | 06/18/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DD1966 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |