| Legacy Smiles Of Southern Az | |
|
261 W Duval Road Green Valley AZ 85614 | |
| (520) 625-0131 | |
| (520) 625-6998 |
| Full Name | Legacy Smiles Of Southern Az |
|---|---|
| Speciality | Dentist |
| Location | 261 W Duval Road, Green Valley, Arizona |
| Authorized Official Name and Position | Dawnie Kildo (OWNER) |
| Authorized Official Contact | 5206250131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Smiles Of Southern Az 261 W Duval Road Green Valley AZ 85614 Ph: (520) 625-0131 | Legacy Smiles Of Southern Az 261 W Duval Road Green Valley AZ 85614 Ph: (520) 625-0131 |
| NPI Number | 1548656457 |
|---|---|
| Provider Enumeration Date | 04/08/2015 |
| Last Update Date | 07/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548656457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D5331 (Arizona) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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