| Kethcart Smiles Pllc | |
|
1277 E Missouri Ave Ste 102 Phoenix AZ 85014-2916 | |
| (602) 615-8516 | |
| (602) 883-7252 |
| Full Name | Kethcart Smiles Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1277 E Missouri Ave Ste 102, Phoenix, Arizona |
| Authorized Official Name and Position | Stephanie Kethcart (OWNER) |
| Authorized Official Contact | 6026158516 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kethcart Smiles Pllc 1277 E Missouri Ave Ste 102 Phoenix AZ 85014-2916 Ph: (602) 615-8516 | Kethcart Smiles Pllc 1277 E Missouri Ave Ste 102 Phoenix AZ 85014-2916 Ph: (602) 615-8516 |
| NPI Number | 1245680438 |
|---|---|
| Provider Enumeration Date | 06/17/2016 |
| Last Update Date | 08/10/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245680438 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D6695 (Arizona) | Primary |
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