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Organization

KIDS INTEGRATIVE NORTERRA DENTISTRY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BEN J HIMMELSTEIN ESQ. (CHIEF LEGAL OFFICER)
(480) 229-7498
Entity
Organization

Contact information

Practice address
2460 W HAPPY VALLEY RD STE 1189, PHOENIX, AZ 85085-8511
(602) 833-2564
Mailing address
1934 E CAMELBACK RD STE 110, PHOENIX, AZ 85016-4136
(602) 833-2564

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
03/02/2026
Last updated
03/02/2026
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