| Kids 2 Dentist Dental Group | |
|
1814 N Dinuba Blvd Visalia CA 93291-3014 | |
| (323) 203-2564 | |
| Not Available |
| Full Name | Kids 2 Dentist Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 1814 N Dinuba Blvd, Visalia, California |
| Authorized Official Name and Position | Jerry Lee Lanier (PRESIDENT/OWNER) |
| Authorized Official Contact | 3232032564 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids 2 Dentist Dental Group 5449 Hollywood Blvd Ste A Los Angeles CA 90027-3454 Ph: (323) 203-2564 | Kids 2 Dentist Dental Group 1814 N Dinuba Blvd Visalia CA 93291-3014 Ph: (323) 203-2564 |
| NPI Number | 1356094155 |
|---|---|
| Provider Enumeration Date | 02/01/2022 |
| Last Update Date | 03/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356094155 | NPI | - | NPPES |
| 1356489660 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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