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Organization

KIDS CAVITY PREVENTION PROGRAM INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SUSANA WELLS-SANDOVAL (PRESIDENT)
(509) 949-3095
Entity
Organization

Contact information

Practice address
8 E WASHINGTON AVE STE 202, YAKIMA, WA 98903-1683
(509) 949-3095
Mailing address
8 E WASHINGTON AVE STE 202, YAKIMA, WA 98903-1683
(509) 949-3095

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
WA7925
WA

Other

Enumeration date
08/11/2010
Last updated
01/30/2012
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