# JUST FOR KIDS GENERAL DENTISTRY, PC

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

## Provider details

- **NPI number:** 1063602605
- **Authorized official:** DR. RONALD ANTHONY DICARLO II D,M,D (PRESIDENT/OWNER)
- **Authorized official phone:** (928) 718-7188

## Contact information

- **Practice address:** 1111 RIATA VALLEY RD, STE 300, KINGMAN, AZ 86409-3678
- **Practice address phone:** (928) 692-9315
- **Practice address fax:** (928) 692-9408
- **Mailing address:** 2401 STOCKTON HILL RD, SUITE 1, KINGMAN, AZ 86401-4189
- **Mailing address phone:** (928) 718-7188
- **Mailing address fax:** (928) 718-7189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 07/30/2007
- **Last updated:** 04/16/2008