Organization
CHILDREN'S DENTAL CENTRE OF IRVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REENA KUBA DDS, MS (DENTIST)
(214) 293-2186
Entity
Organization
Contact information
Practice address
8870 N MACARTHUR BLVD, A101, IRVING, TX 75063-7833
(214) 484-3199
Mailing address
8870 N MACARTHUR BLVD, A101, IRVING, TX 75063-7833
(214) 484-3199
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
21765
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164516902
—
TX
Enumeration date
08/11/2010
Last updated
08/11/2010
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