Organization · Type 2 NPI

Children's Medicaid Dental Clinic, PC

General Practice Dentistry · Phoenix, AZ

NPI number 1326025974 Active

Practice location

5115 W Thomas Rd
Phoenix, AZ 85031-3944

Call (602) 233-3133 Map

Fax (602) 278-3139

Mailing address

201 W 8th St, Suite 810
Pueblo, CO 81003-3038

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

3 other providers at this address

Other general practice dentistry providers in Phoenix

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NPI record

NPI: 1326025974
Entity type: Organization (Type 2)
Issued: Dec 26, 2005
Last updated: May 17, 2010
Status: Active

Other names

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Children's Dental Clinic of W. Thomas Rd. · doing business as

Authorized official

Ms. Trudy Williams
Director, Licensing & Credentialing
(615) 750-0342

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1326025974

Children's Medicaid Dental Clinic, PC's National Provider Identifier is 1326025974, issued on Dec 26, 2005. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Phoenix, AZ. The record was last updated on May 17, 2010.