Organization
KID-1 PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ALLEN JENNINGS DDS (PRESIDENT)
(520) 876-5431
Entity
Organization
Contact information
Practice address
907 E COTTONWOOD LN STE 1, CASA GRANDE, AZ 85222-2226
(520) 876-5431
(520) 876-4875
Mailing address
907 E COTTONWOOD LN STE 1, CASA GRANDE, AZ 85222-2226
(520) 876-5431
(520) 876-4875
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D4544
AZ
Other
Enumeration date
04/19/2007
Last updated
08/22/2020
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