Organization
HOME DENTAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH KUCERA (PRESIDENT)
(303) 526-7739
Entity
Organization
Contact information
Practice address
2942 N 24TH ST, #114, PHOENIX, AZ 85016-7844
(303) 526-7739
Mailing address
2942 N 24TH ST, #114, PHOENIX, AZ 85016-7844
(303) 526-7739
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/08/2009
Last updated
12/08/2009
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