| Cochise Children's Dental Center | |
|
2273 E Wilcox Dr Sierra Vista AZ 85635-2755 | |
| (520) 458-1835 | |
| (520) 459-4145 |
| Full Name | Cochise Children's Dental Center |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2273 E Wilcox Dr, Sierra Vista, Arizona |
| Authorized Official Name and Position | Larry Dean Bloom (PRESIDENT) |
| Authorized Official Contact | 5204581835 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cochise Children's Dental Center 2273 E Wilcox Dr Sierra Vista AZ 85635-2755 Ph: (520) 458-1835 | Cochise Children's Dental Center 2273 E Wilcox Dr Sierra Vista AZ 85635-2755 Ph: (520) 458-1835 |
| NPI Number | 1457422669 |
|---|---|
| Provider Enumeration Date | 11/10/2006 |
| Last Update Date | 03/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457422669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D3807 (Arizona) | Primary |
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