Organization
IKIDS PEDIATRIC DENTISTRY ARLINGTON
Active
Other names
WeeCare
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSSA AGUILAR (DIRECTOR OF REVENUE & CREDENTIALING)
(817) 466-8554
Entity
Organization
Contact information
Practice address
3801 S COOPER ST STE 109, ARLINGTON, TX 76015
(817) 467-9089
(817) 472-9008
Mailing address
2500 E BROAD ST STE 204, MANSFIELD, TX 76063-4361
(817) 466-8554
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
24272
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200886401
—
TX
05
—
200886402
—
TX
05
—
200886403
—
TX
05
—
200886404
—
TX
Enumeration date
09/13/2011
Last updated
03/08/2021
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