Organization · NPI-2
A Kidz Clinic
Dental Hygienist · Delta, CO
NPI number1093472268
StatusActive
Last updated in NPPESAug 2, 2023
Details
- NPI
- 1093472268
- Entity type
- Organization (NPI-2)
- Legal business name
- A Kidz Clinic
- Organization subpart
- No
- Enumeration date
- Nov 23, 2021
- Certification date
- Aug 2, 2023
- Last updated
- Aug 2, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 124Q00000X | Dental Hygienist | – | – | Yes |
| 1223G0001X | Dentist, General Practice | – | – |
Other names
- A Kidz Clinic (Doing Business As)
Practice location
360 E 8th StDelta, CO 81416-2379
Phone 970-874-2753 · Fax 970-874-2943
Mailing address
360 E 8th StDelta, CO 81416-2379
Phone 970-874-2753 · Fax 970-399-7005
Authorized official
Diane Dockter
Executive Director
9708742753
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