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Organization

JUST FOR KIDS GENERAL DENTISTRY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RONALD ANTHONY DICARLO II D,M,D (PRESIDENT/OWNER)
(928) 718-7188
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
07/30/2007
Last updated
04/16/2008
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