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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 | |||
General Practice |
1223G0001X |
| NPI # | 1407561590 |
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| LBN Legal business name | KIDSPACE PEDIATRIC DENTISTRY PARTNERSHIP | ||||||||||||
| Authorized official | JULIE LE - (PRACTICE ADMINISTRATOR) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 01/23/2023 | ||||||||||||
| Last updated | 01/23/2023 - About 3 years ago | ||||||||||||
| Identifiers |
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KIDSPACE PEDIATRIC DENTISTRY PARTNERSHIP