| Tiny Teeth Pediatric Dentistry, Llc | |
|
3933 N. Maize Rd Suite 200 Wichita KS 67205-6710 | |
| (316) 202-0140 | |
| (316) 202-0141 |
| Full Name | Tiny Teeth Pediatric Dentistry, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3933 N. Maize Rd, Wichita, Kansas |
| Authorized Official Name and Position | Matthew Healy (MEMBER/MANAGER) |
| Authorized Official Contact | 9132208907 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tiny Teeth Pediatric Dentistry, Llc 3933 N Maize Rd Ste 200 Maize KS 67101-9619 Ph: (316) 202-0140 | Tiny Teeth Pediatric Dentistry, Llc 3933 N. Maize Rd Suite 200 Wichita KS 67205-6710 Ph: (316) 202-0140 |
| NPI Number | 1679041644 |
|---|---|
| Provider Enumeration Date | 11/08/2018 |
| Last Update Date | 11/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679041644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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