| Wild West Kids Dental Bullhead | |
|
2401 Miracle Mile Bullhead City AZ 86442-7311 | |
| (928) 704-5573 | |
| Not Available |
| Full Name | Wild West Kids Dental Bullhead |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2401 Miracle Mile, Bullhead City, Arizona |
| Authorized Official Name and Position | Ronald A Dicarlo (OWNER) |
| Authorized Official Contact | 9287187188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild West Kids Dental Bullhead 2401 N Stockton Hill Rd Ste 1 Kingman AZ 86401-4189 Ph: (928) 718-7188 | Wild West Kids Dental Bullhead 2401 Miracle Mile Bullhead City AZ 86442-7311 Ph: (928) 704-5573 |
| NPI Number | 1932799053 |
|---|---|
| Provider Enumeration Date | 01/22/2021 |
| Last Update Date | 01/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932799053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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