| Smile Wide | |
|
4024 12th St Riverside CA 92501-3561 | |
| (951) 784-0636 | |
| (951) 784-0675 |
| Full Name | Smile Wide |
|---|---|
| Speciality | Dentist |
| Location | 4024 12th St, Riverside, California |
| Authorized Official Name and Position | Kiavash Kevin Badii (PRESIDENT) |
| Authorized Official Contact | 9495968100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Wide 1920 Main St Ste 970 Irvine CA 92614-8275 Ph: (949) 596-8100 | Smile Wide 4024 12th St Riverside CA 92501-3561 Ph: (951) 784-0636 |
| NPI Number | 1114317690 |
|---|---|
| Provider Enumeration Date | 02/04/2015 |
| Last Update Date | 02/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114317690 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 54538 (California) | Primary |
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