| Kids Dental Kare | |
|
1127 E Green St Pasadena CA 91106-2505 | |
| (323) 345-0337 | |
| Not Available |
| Full Name | Kids Dental Kare |
|---|---|
| Speciality | Dentist |
| Location | 1127 E Green St, Pasadena, California |
| Authorized Official Name and Position | Jerry L Lanier (CEO/PRESIDENT) |
| Authorized Official Contact | 3233450337 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Dental Kare 1127 E Green St Pasadena CA 91106-2505 Ph: (323) 345-0337 | Kids Dental Kare 1127 E Green St Pasadena CA 91106-2505 Ph: (323) 345-0337 |
| NPI Number | 1477866275 |
|---|---|
| Provider Enumeration Date | 07/21/2010 |
| Last Update Date | 07/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477866275 | NPI | - | NPPES |
| 1356489660 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 40088 (California) | Primary |
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