| Littlegrins , P.l.l.c | |
|
2179 W 24th St Ste B Yuma AZ 85364-6163 | |
| (928) 782-4708 | |
| (928) 782-2212 |
| Full Name | Littlegrins , P.l.l.c |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2179 W 24th St Ste B, Yuma, Arizona |
| Authorized Official Name and Position | Joseph Drew Gallemore (OWNER) |
| Authorized Official Contact | 9287824708 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Littlegrins , P.l.l.c 2179 W 24th St Ste B Yuma AZ 85364-6163 Ph: (928) 782-4708 | Littlegrins , P.l.l.c 2179 W 24th St Ste B Yuma AZ 85364-6163 Ph: (928) 782-4708 |
| NPI Number | 1033473103 |
|---|---|
| Provider Enumeration Date | 07/03/2012 |
| Last Update Date | 07/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033473103 | NPI | - | NPPES |
| 155269002 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 4390 (Arizona) | Primary |
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