Provider Demographics
NPI:1942387204
Name:ALBERT M. HIGGINS, DDS, PLLC
Entity Type:Organization
Organization Name:ALBERT M. HIGGINS, DDS, PLLC
Other - Org Name:KIDZAAM DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:MITCHEL
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:928-445-8033
Mailing Address - Street 1:1300 W GURLEY ST
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-2852
Mailing Address - Country:US
Mailing Address - Phone:928-445-8033
Mailing Address - Fax:928-443-1373
Practice Address - Street 1:1300 W GURLEY ST STE 1
Practice Address - Street 2:SUITE ONE
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-2852
Practice Address - Country:US
Practice Address - Phone:928-445-8033
Practice Address - Fax:928-443-1373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty