Organization
KIDZ R KOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CELESTE BRENKE (OFFICE MANAGER/OWNER)
(623) 572-5777
Entity
Organization
Contact information
Practice address
7505 W DEER VALLEY RD, SUITE 110, PEORIA, AZ 85382-2107
(623) 572-5777
(623) 572-7288
Mailing address
7505 W DEER VALLEY RD, SUITE 110, PEORIA, AZ 85382-2107
(623) 572-5777
(623) 572-7288
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390493-004
—
AZ
Enumeration date
04/08/2015
Last updated
04/08/2015
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