| Wow Smiles | |
|
1252 Airport Park Blvd Suite A-1 Ukiah CA 95482 | |
| (707) 583-8969 | |
| Not Available |
| Full Name | Wow Smiles |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1252 Airport Park Blvd, Ukiah, California |
| Authorized Official Name and Position | Cynthia J Russo (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 7072305602 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wow Smiles Po Box 2791 Santa Rosa CA 95405-0791 Ph: (707) 583-8969 | Wow Smiles 1252 Airport Park Blvd Suite A-1 Ukiah CA 95482 Ph: (707) 583-8969 |
| NPI Number | 1093196651 |
|---|---|
| Provider Enumeration Date | 06/09/2015 |
| Last Update Date | 08/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093196651 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | () | Primary |
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