Organization
KIDZANIA DENTAL, LLC
Active
Other names
Kidzania Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUSSAM GHARRAPH (OWNER)
(817) 483-2445
Entity
Organization
Contact information
Practice address
26785 E. UNIVERSITY DR, ST. 102, AUBREY, TX 75068
(817) 483-2445
(817) 483-2677
Mailing address
3851 SW GREEN OAKS BLVD, ST. 123, ARLINGTON, TX 76017
(817) 483-2445
(817) 483-2677
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
29173
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
28910
TX
Other
Enumeration date
01/12/2018
Last updated
01/12/2018
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