| Smiles for Miles | |
|
2020 Coffee Rd Ste E Modesto CA 95355-2427 | |
| (209) 571-9855 | |
| (209) 571-9874 |
| Full Name | Smiles for Miles |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2020 Coffee Rd Ste E, Modesto, California |
| Authorized Official Name and Position | Lea Manosov (OWNER) |
| Authorized Official Contact | 2095719855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles for Miles 2020 Coffee Rd Ste E Modesto CA 95355-2421 Ph: (209) 571-9855 | Smiles for Miles 2020 Coffee Rd Ste E Modesto CA 95355-2427 Ph: (209) 571-9855 |
| NPI Number | 1225169683 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 01/22/2021 |
| Certification Date | 01/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225169683 | NPI | - | NPPES |
| G92664-01 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 48326 (California) | Primary |
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