| Smile Wide | |
|
710 S Brookhurst Street Suite O Anaheim CA 92804-4321 | |
| (714) 780-5665 | |
| (714) 490-1585 |
| Full Name | Smile Wide |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 710 S Brookhurst Street, Anaheim, California |
| Authorized Official Name and Position | Daniel Harvey Lee (PRESIDENT) |
| Authorized Official Contact | 9495968100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Wide 19762 Macarthur Blvd. 100 Irvine CA 92612-8275 Ph: (949) 596-8100 | Smile Wide 710 S Brookhurst Street Suite O Anaheim CA 92804-4321 Ph: (714) 780-5665 |
| NPI Number | 1063802551 |
|---|---|
| Provider Enumeration Date | 02/04/2015 |
| Last Update Date | 11/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063802551 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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