Provider Demographics
NPI:1043606171
Name:HEALTHY KIDS KAMPUS, PC
Entity type:Organization
Organization Name:HEALTHY KIDS KAMPUS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:CAPUTO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MA
Authorized Official - Phone:520-975-4927
Mailing Address - Street 1:4723 E CAMP LOWELL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1256
Mailing Address - Country:US
Mailing Address - Phone:520-975-4927
Mailing Address - Fax:
Practice Address - Street 1:910 W IRVINGTON RD
Practice Address - Street 2:SUITE 170A
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-2458
Practice Address - Country:US
Practice Address - Phone:520-975-4927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty