Ikids Pediatric Dentistry, Pc | |
1756 Broad Park Cir N Ste 100 Mansfield TX 76063 | |
(817) 453-2800 | |
(817) 453-2825 |
Full Name | Ikids Pediatric Dentistry, Pc |
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Speciality | Dentist - Pediatric Dentistry |
Location | 1756 Broad Park Cir N Ste 100, Mansfield, Texas |
Authorized Official Name and Position | Alyssa Aguilar (DIRECTOR OF REVENUE & CREDENTIALING) |
Authorized Official Contact | 8174668554 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Ikids Pediatric Dentistry, Pc 2500 E Broad St Ste 204 Mansfield TX 76063-4361 Ph: (817) 466-8554 | Ikids Pediatric Dentistry, Pc 1756 Broad Park Cir N Ste 100 Mansfield TX 76063 Ph: (817) 453-2800 |
NPI Number | 1043442387 |
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Provider Enumeration Date | 08/20/2009 |
Last Update Date | 03/04/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043442387 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 24272 (Texas) | Primary |
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