STAN KIDTASTIC DENTAL LLC NPI 1558902247

NPI Information

STAN KIDTASTIC DENTAL LLC is a pediatric dentistry dentist in San Tan Valley, AZ. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. STAN KIDTASTIC DENTAL LLC NPI is 1558902247. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2510 E HUNT HWY STE 29
SAN TAN VALLEY, AZ
ZIP 85143-208
Phone: (480) 457-4693

The provider's authorized official is Faith Gaskins .
The authorized official title is Director Of Credentialing and has the following contact phone number (972) 869-3789.

The enumeration date for this NPI number is 10/3/2019 and was last updated on 10/3/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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