| Your Special Smiles Pllc | |
|
905 Shoshone St N Twin Falls ID 83301-6363 | |
| (208) 859-8449 | |
| Not Available |
| Full Name | Your Special Smiles Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 905 Shoshone St N, Twin Falls, Idaho |
| Authorized Official Name and Position | Brooke Marie-osgood Fukuoka (OWNER) |
| Authorized Official Contact | 2088598449 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Special Smiles Pllc Po Box 195 Jerome ID 83338-0195 Ph: (208) 859-8449 | Your Special Smiles Pllc 905 Shoshone St N Twin Falls ID 83301-6363 Ph: (208) 859-8449 |
| NPI Number | 1467820068 |
|---|---|
| Provider Enumeration Date | 09/14/2015 |
| Last Update Date | 09/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467820068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4533 (Idaho) | Primary |
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