| Smiles 4 Kids, Llc | |
|
4337 E Main St Ste 205 Farmington NM 87402-8633 | |
| (970) 247-0202 | |
| Not Available |
| Full Name | Smiles 4 Kids, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4337 E Main St, Farmington, New Mexico |
| Authorized Official Name and Position | J Ryan Mickelson (PRESIDENT) |
| Authorized Official Contact | 9702470174 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles 4 Kids, Llc 4337 E Main St Ste 205 Farmington NM 87402-8633 Ph: () - | Smiles 4 Kids, Llc 4337 E Main St Ste 205 Farmington NM 87402-8633 Ph: (970) 247-0202 |
| NPI Number | 1346516929 |
|---|---|
| Provider Enumeration Date | 03/28/2012 |
| Last Update Date | 03/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346516929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8630 (Colorado) | Primary |
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