# KIDS CAVITY PREVENTION PROGRAM INC.

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

## Provider details

- **NPI number:** 1659686848
- **Authorized official:** MS. SUSANA WELLS-SANDOVAL (PRESIDENT)
- **Authorized official phone:** (509) 949-3095

## Contact information

- **Practice address:** 8 E WASHINGTON AVE STE 202, YAKIMA, WA 98903-1683
- **Practice address phone:** (509) 949-3095
- **Mailing address:** 8 E WASHINGTON AVE STE 202, YAKIMA, WA 98903-1683
- **Mailing address phone:** (509) 949-3095

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | WA7925 | WA | Yes |

## Other

- **Enumeration date:** 08/11/2010
- **Last updated:** 01/30/2012