# METRO KIDZ DENTAL, PC

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

## Provider details

- **NPI number:** 1063836567
- **Authorized official:** SCOTT GOLDMAN (PRESIDENT)
- **Authorized official phone:** (847) 987-0322

## Contact information

- **Practice address:** 808 E SIBLEY BLVD, DOLTON, IL 60419-2130
- **Practice address phone:** (847) 987-0322
- **Mailing address:** 808 E SIBLEY BLVD, DOLTON, IL 60419-2130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 019027333 | IL | Yes |

## Other

- **Enumeration date:** 02/05/2014
- **Last updated:** 02/05/2014