| Smiles 4 Kids | |
|
1315 S Hwy 89 Suite 102 Jackson WY 83001-8514 | |
| (208) 716-9724 | |
| Not Available |
| Full Name | Smiles 4 Kids |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1315 S Hwy 89, Jackson, Wyoming |
| Authorized Official Name and Position | Kory D Bingham (OWNER) |
| Authorized Official Contact | 2087169724 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles 4 Kids Po Box 191 Iona ID 83427-0191 Ph: (208) 716-9724 | Smiles 4 Kids 1315 S Hwy 89 Suite 102 Jackson WY 83001-8514 Ph: (208) 716-9724 |
| NPI Number | 1184999542 |
|---|---|
| Provider Enumeration Date | 03/19/2012 |
| Last Update Date | 04/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184999542 | NPI | - | NPPES |
| 1124183207 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 1361 (Wyoming) | Primary |
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