Organization
IKIDS CHILDRENS DENTISTRY PLLC RANDOLPH WADE HAMILTON III SOLE MBR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA PERKINS (ONBOARDING SPECIALIST)
(678) 244-4844
Entity
Organization
Contact information
Practice address
7451 N BEACH ST STE 140, FORT WORTH, TX 76137-5160
(817) 295-1144
Mailing address
2970 BRANDYWINE RD STE 200, ATLANTA, GA 30341-5528
(770) 692-1000
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
07/08/2021
Last updated
07/08/2021
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