# VISALIA CHILDREN'S DENTAL SURGERY CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053643783
- **Authorized official:** MR. DEVIN LARSEN (CEO)
- **Authorized official phone:** (208) 340-1840

## Contact information

- **Practice address:** 136 ASPEN COURT, SUITE A, VISALIA, CA 93291
- **Practice address phone:** (559) 625-9300
- **Practice address fax:** (559) 625-9330
- **Mailing address:** 9709 LAKESIDE BLVD STE 350, SPRING, TX 77381-1213
- **Mailing address phone:** (713) 489-2198
- **Mailing address fax:** (713) 489-2978

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 23135 | CA | Yes |

## Other

- **Enumeration date:** 02/05/2010
- **Last updated:** 01/27/2025