Organization
COMMUNITY DENTAL FOR KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES MCKENZIE DDS (OWNER)
(480) 734-4712
Entity
Organization
Contact information
Practice address
1108 W DICKINSON BLVD STE B, FORT STOCKTON, TX 79735-4201
(480) 734-4712
Mailing address
2131 E LELAND CIR, MESA, AZ 85213-2240
(480) 734-4712
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
27638
TX
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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