| Great Grins Children's Dentistry, P.l.l.c. | |
|
3953 E Paradise Falls Dr Suite 110 Tucson AZ 85712-6688 | |
| (520) 325-4746 | |
| (520) 319-1031 |
| Full Name | Great Grins Children's Dentistry, P.l.l.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3953 E Paradise Falls Dr, Tucson, Arizona |
| Authorized Official Name and Position | Angela Michele Wolfman (DOCTOR/OWNER) |
| Authorized Official Contact | 5203254746 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Grins Children's Dentistry, P.l.l.c. 3953 E Paradise Falls Dr Suite 110 Tucson AZ 85712-6688 Ph: (520) 325-4746 | Great Grins Children's Dentistry, P.l.l.c. 3953 E Paradise Falls Dr Suite 110 Tucson AZ 85712-6688 Ph: (520) 325-4746 |
| NPI Number | 1134499007 |
|---|---|
| Provider Enumeration Date | 01/09/2012 |
| Last Update Date | 05/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134499007 | NPI | - | NPPES |
| 977473 | Medicaid | AZ | |
| 967177 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 6632 (Arizona) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | 6742 (Arizona) | Secondary |
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