| Smile Wide | |
|
3325 Palo Verde Avenue Suite 208 Long Beach CA 90808-4132 | |
| (562) 429-1642 | |
| (562) 429-1643 |
| Full Name | Smile Wide |
|---|---|
| Speciality | Dentist |
| Location | 3325 Palo Verde Avenue, Long Beach, California |
| Authorized Official Name and Position | Daniel Harvey Lee (PRESIDENT) |
| Authorized Official Contact | 9495968100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Wide 19762 Macarthur Blvd. 100 Irvine CA 92612-8275 Ph: (949) 596-8100 | Smile Wide 3325 Palo Verde Avenue Suite 208 Long Beach CA 90808-4132 Ph: (562) 429-1642 |
| NPI Number | 1023408507 |
|---|---|
| Provider Enumeration Date | 02/04/2015 |
| Last Update Date | 12/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023408507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 56861 (California) | Primary |
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