| Waco Kids Dental Pc | |
|
1121 Lake Air Dr Waco TX 76710-4417 | |
| (254) 772-8330 | |
| Not Available |
| Full Name | Waco Kids Dental Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1121 Lake Air Dr, Waco, Texas |
| Authorized Official Name and Position | Aaron Blackwelder (PRESIDENT) |
| Authorized Official Contact | 2547728330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waco Kids Dental Pc 1121 Lake Air Dr Waco TX 76710-4417 Ph: (254) 772-8330 | Waco Kids Dental Pc 1121 Lake Air Dr Waco TX 76710-4417 Ph: (254) 772-8330 |
| NPI Number | 1598041659 |
|---|---|
| Provider Enumeration Date | 11/02/2011 |
| Last Update Date | 11/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598041659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 22764 (Texas) | Primary |
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