Organization · NPI-2

A Tooth Doctor For Kids Dallas PLLC

Dentist · Phoenix, AZ

NPI number1962790626
StatusActive
Last updated in NPPESJul 15, 2011

Details

NPI
1962790626
Entity type
Organization (NPI-2)
Legal business name
A Tooth Doctor For Kids Dallas PLLC
Organization subpart
No
Enumeration date
Jul 15, 2011
Last updated
Jul 15, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist––Yes

Other names

  • A Tooth Doctor For Kids (Doing Business As)

Practice location

3301 E Thomas Rd
Phoenix, AZ 85018-7302

Phone 602-956-4411 · Fax 602-956-7755

Mailing address

4550 Gus Thomasson Rd
Mesquite, TX 75150-1700

Phone 512-371-1222 · Fax 614-462-2616

Authorized official

Malcolm Ray Scott
Owner
6029564411

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