Provider Demographics
NPI:1821821711
Name:DENTISTRY FOR CHILDREN & ADOLESCENTS, PC
Entity type:Organization
Organization Name:DENTISTRY FOR CHILDREN & ADOLESCENTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS-CORDERO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:941-284-4069
Mailing Address - Street 1:7307 MERCHANT CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8486
Mailing Address - Country:US
Mailing Address - Phone:941-907-7762
Mailing Address - Fax:941-373-6442
Practice Address - Street 1:7307 MERCHANT CT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34240-8486
Practice Address - Country:US
Practice Address - Phone:941-907-7762
Practice Address - Fax:941-373-6442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty