| First Smiles Children's Dentistry | |
|
1801 Tully Road Suite B Modesto CA 95350 | |
| (209) 343-3500 | |
| (209) 527-1971 |
| Full Name | First Smiles Children's Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1801 Tully Road, Modesto, California |
| Authorized Official Name and Position | Corey Robert Acree (PRESIDENT) |
| Authorized Official Contact | 2095290674 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| First Smiles Children's Dentistry 1801 Tully Road Suite B Modesto CA 95350 Ph: (209) 343-3500 | First Smiles Children's Dentistry 1801 Tully Road Suite B Modesto CA 95350 Ph: (209) 343-3500 |
| NPI Number | 1427021757 |
|---|---|
| Provider Enumeration Date | 02/08/2006 |
| Last Update Date | 08/05/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427021757 | NPI | - | NPPES |
| 20789 | Other | CA | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 48870 (California) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | 48880 (California) | Primary |
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Great Smiles Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 Phone: 209-409-8987 Fax: 209-322-4749 |