Organization
CHILDREN'S DENTISTRY OF KYLE
Active
Parent organization
CHILDREN'S DENTISTRY OF KYLE
Other names
Children's Dentistry of Gonzales
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S DENTISTRY OF KYLE
Authorized official
DR. JEREMY WITTICH DDS (OWNER/PROVIDER)
(512) 268-4400
Entity
Organization
Contact information
Practice address
1110 N SARAH DEWITT DR, GONZALES, TX 78629-3311
(512) 268-4400
(512) 268-4402
Mailing address
1110 N SARAH DEWITT DR, GONZALES, TX 78629-3311
(512) 268-4400
(512) 268-4402
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22616
TX
Other
Enumeration date
11/18/2010
Last updated
11/18/2010
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