Mykidzdentist Central Phoenix | |
1728 W Glendale Ave #305 Phoenix AZ 85021-8860 | |
(602) 995-7336 | |
(602) 995-2665 |
Full Name | Mykidzdentist Central Phoenix |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 1728 W Glendale Ave, Phoenix, Arizona |
Authorized Official Name and Position | Ernest Nehrer (PRESIDENT) |
Authorized Official Contact | 8312345526 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mykidzdentist Central Phoenix 1728 W Glendale Ave #305 Phoenix AZ 85021-8860 Ph: (602) 995-7336 | Mykidzdentist Central Phoenix 1728 W Glendale Ave #305 Phoenix AZ 85021-8860 Ph: (602) 995-7336 |
NPI Number | 1316302599 |
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Provider Enumeration Date | 12/15/2015 |
Last Update Date | 12/15/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316302599 | NPI | - | NPPES |
955781 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 8935 (Arizona) | Primary |
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