| Smiles 4 Kids Jackson Llc | |
|
1315 S Hwy 89 Suite 102 Jackson WY 83001-8514 | |
| (208) 716-9724 | |
| Not Available |
| Full Name | Smiles 4 Kids Jackson Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1315 S Hwy 89, Jackson, Wyoming |
| Authorized Official Name and Position | Kory D Bingham (OWNER) |
| Authorized Official Contact | 2087169724 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles 4 Kids Jackson Llc Po Box 191 Iona ID 83427-0191 Ph: (208) 716-9724 | Smiles 4 Kids Jackson Llc 1315 S Hwy 89 Suite 102 Jackson WY 83001-8514 Ph: (208) 716-9724 |
| NPI Number | 1184999542 |
|---|---|
| Provider Enumeration Date | 03/19/2012 |
| Last Update Date | 04/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184999542 | NPI | - | NPPES |
| 1124183207 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 1361 (Wyoming) | Primary |
Rj Smiles, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 West Broadway Ave, Suite 106, Jackson, WY 83001 Phone: 307-732-2273 Fax: 307-732-1660 | |
Owens Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 S Hwy 89, Jackson, WY 83001 Phone: 307-733-3848 Fax: 307-733-8978 | |
Nathan Tanner Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 E Broadway, Jackson, WY 83001 Phone: 307-733-2555 | |
Teton Oral & Maxillofacial Surgery Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1160 Alpine Lane, #1d, Jackson, WY 83002 Phone: 307-739-8611 Fax: 307-739-8613 | |
Larsen Family Dentistry, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3103 W Big Trail Dr, Jackson, WY 83001 Phone: 307-733-4778 Fax: 307-734-8041 | |
James L. Derrico Dds Llc Dental Clinic Medicare: Medicare Enrolled Practice Location: 1130 S Hwy 89, Jackson, WY 83001 Phone: 307-200-6644 |