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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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatric Dentistry |
1223P0221X |
| NPI # | 1033242144 |
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| LBN Legal business name | CENTRAL COAST PEDIATRIC DENTAL GROUP | ||||||||
| Authorized official | ANNA LIZAOLA - (ADMINISTRATIVE ASSISTANT) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 03/14/2007 | ||||||||
| Last updated | 03/25/2021 - About 5 years ago | ||||||||
| Identifiers |
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CENTRAL COAST PEDIATRIC DENTAL GROUP