| Smiles 4 Kids | |
|
621 Jensen Grove Dr Blackfoot ID 83221-1685 | |
| (208) 785-4696 | |
| Not Available |
| Full Name | Smiles 4 Kids |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 621 Jensen Grove Dr, Blackfoot, Idaho |
| Authorized Official Name and Position | Kory D Bingham (MANAGING PARTNER) |
| Authorized Official Contact | 2085293007 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles 4 Kids 621 Jensen Grove Dr Blackfoot ID 83221-1685 Ph: (208) 785-4696 | Smiles 4 Kids 621 Jensen Grove Dr Blackfoot ID 83221-1685 Ph: (208) 785-4696 |
| NPI Number | 1154799047 |
|---|---|
| Provider Enumeration Date | 09/09/2015 |
| Last Update Date | 09/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154799047 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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