Provider Demographics
NPI:1982468153
Name:NEW KIDS DENTAL
Entity Type:Organization
Organization Name:NEW KIDS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:THU
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN HO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-658-8604
Mailing Address - Street 1:316 OLD POINTE SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8978
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:316 OLD POINTE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-8978
Practice Address - Country:US
Practice Address - Phone:803-658-8604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty