| Kinder Pediatric Dental Specialist, Pllc | |
|
209 W. Apache Trail Apache Junction AZ 85120 | |
| (480) 288-5955 | |
| (480) 288-4345 |
| Full Name | Kinder Pediatric Dental Specialist, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 209 W. Apache Trail, Apache Junction, Arizona |
| Authorized Official Name and Position | Edward Esser Dove (MEMBER) |
| Authorized Official Contact | 8186447124 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kinder Pediatric Dental Specialist, Pllc 11442 E Bells Visits Dr Scottsdale AZ 85259 Ph: (480) 288-5955 | Kinder Pediatric Dental Specialist, Pllc 209 W. Apache Trail Apache Junction AZ 85120 Ph: (480) 288-5955 |
| NPI Number | 1972796605 |
|---|---|
| Provider Enumeration Date | 08/27/2007 |
| Last Update Date | 05/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972796605 | NPI | - | NPPES |
| G9398501 | Medicaid | CA | |
| 456229 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | 51010 (California) | Secondary |
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