Organization
TINY TEETH PEDIATRIC DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW HEALY DDS (MEMBER/MANAGER)
(913) 220-8907
Entity
Organization
Contact information
Practice address
3933 N. MAIZE RD, SUITE 200, WICHITA, KS 67205-6710
(316) 202-0140
(316) 202-0141
Mailing address
3933 N MAIZE RD STE 200, MAIZE, KS 67101-9619
(316) 202-0140
(316) 204-0141
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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