| My Kid's Smile | |
|
10645 Double R Blvd Reno NV 89521-8920 | |
| (775) 852-6164 | |
| (775) 284-7352 |
| Full Name | My Kid's Smile |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 10645 Double R Blvd, Reno, Nevada |
| Authorized Official Name and Position | J Justin Wilkerson (MANAGER) |
| Authorized Official Contact | 7758239797 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Kid's Smile 10645 Double R Blvd Reno NV 89521-8920 Ph: (775) 852-6164 | My Kid's Smile 10645 Double R Blvd Reno NV 89521-8920 Ph: (775) 852-6164 |
| NPI Number | 1720346117 |
|---|---|
| Provider Enumeration Date | 04/24/2012 |
| Last Update Date | 11/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720346117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | S6-20 (Nevada) | Primary |
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