| Kiddo Smiles Dental | |
|
1132 Independence Ave Marion OH 43302-6318 | |
| (740) 383-3223 | |
| (740) 375-0278 |
| Full Name | Kiddo Smiles Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1132 Independence Ave, Marion, Ohio |
| Authorized Official Name and Position | Chun Wong (OWNER) |
| Authorized Official Contact | 6142181820 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kiddo Smiles Dental 1132 Independence Ave Marion OH 43302-6318 Ph: (740) 383-3223 | Kiddo Smiles Dental 1132 Independence Ave Marion OH 43302-6318 Ph: (740) 383-3223 |
| NPI Number | 1568904878 |
|---|---|
| Provider Enumeration Date | 11/17/2016 |
| Last Update Date | 11/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568904878 | NPI | - | NPPES |
| 2750867 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 30022603 (Ohio) | Primary |
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