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Organization

AZ KIDZ HEALTHY SMILES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KATHLEEN M LUISI RDH (OWNER/RDH)
(617) 913-3321
Entity
Organization

Contact information

Practice address
16167 W DEVONSHIRE AVE, GOODYEAR, AZ 85395-7777
(617) 913-3321
Mailing address
16167 W DEVONSHIRE AVE, GOODYEAR, AZ 85395-7777
(617) 913-3321

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary

Other

Enumeration date
12/07/2022
Last updated
12/07/2022
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