Organization
CHILDREN'S MEDICAID DENTAL CLINIC, PC
Active
Other names
Children's Dental Clinic of W. Thomas Rd.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRUDY WILLIAMS (DIRECTOR, LICENSING & CREDENTIALING)
(615) 750-0342
Entity
Organization
Contact information
Practice address
5115 W THOMAS RD, PHOENIX, AZ 85031-3944
(602) 233-3133
(602) 278-3139
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
619661
—
AZ
Enumeration date
12/26/2005
Last updated
05/17/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us