NPI 1962790626 · live from the CMS NPI Registry
A Tooth Doctor For Kids Dallas PLLC
Dentist in Phoenix, AZ. National Provider Identifier 1962790626, active.
NPI record
| NPI | 1962790626 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist 122300000X |
| Practice location | 3301 E Thomas Rd, Phoenix, AZ 85018 |
| Practice phone | 602-956-4411 |
| Mailing address | 4550 Gus Thomasson Rd, Mesquite, TX 75150 |
| Enumerated | July 15, 2011 |
| Last updated | July 15, 2011 |
| Authorized official | Malcolm Scott, Owner |
| Other names | A Tooth Doctor For Kids |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist primary | 122300000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.