| Super Smiles Maricopa Pllc | |
|
21116 N John Wayne Pkwy Ste B7 Maricopa AZ 85139-2932 | |
| (520) 568-3828 | |
| (520) 568-0443 |
| Full Name | Super Smiles Maricopa Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 21116 N John Wayne Pkwy Ste B7, Maricopa, Arizona |
| Authorized Official Name and Position | Nikita Kuppanda (DDS/ OWNER) |
| Authorized Official Contact | 5205683828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Super Smiles Maricopa Pllc 21116 N John Wayne Pkwy Ste B7 Maricopa AZ 85139-2932 Ph: (520) 568-3828 | Super Smiles Maricopa Pllc 21116 N John Wayne Pkwy Ste B7 Maricopa AZ 85139-2932 Ph: (520) 568-3828 |
| NPI Number | 1891556502 |
|---|---|
| Provider Enumeration Date | 01/19/2024 |
| Last Update Date | 01/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891556502 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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