| Smile Wide | |
|
11351 183rd St Cerritos CA 90703-5434 | |
| (562) 402-9299 | |
| Not Available |
| Full Name | Smile Wide |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 11351 183rd St, Cerritos, California |
| Authorized Official Name and Position | Kiavash Kevin Badii (PRESIDENT) |
| Authorized Official Contact | 7148352383 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Wide 11351 183rd St Cerritos CA 90703-5434 Ph: (562) 402-9299 | Smile Wide 11351 183rd St Cerritos CA 90703-5434 Ph: (562) 402-9299 |
| NPI Number | 1902179658 |
|---|---|
| Provider Enumeration Date | 02/10/2012 |
| Last Update Date | 04/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902179658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (NU) | Secondary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (NU) | Primary |
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