| Super Smiles 4 Kids Cg, Pllc | |
|
1295 E Florence Blvd Ste 4 Casa Grande AZ 85122-4299 | |
| (520) 436-0843 | |
| (520) 436-0105 |
| Full Name | Super Smiles 4 Kids Cg, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1295 E Florence Blvd Ste 4, Casa Grande, Arizona |
| Authorized Official Name and Position | Dora Pesqueda (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 5204360843 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Super Smiles 4 Kids Cg, Pllc 1295 E Florence Blvd Ste 4 Casa Grande AZ 85122-4299 Ph: (520) 436-0843 | Super Smiles 4 Kids Cg, Pllc 1295 E Florence Blvd Ste 4 Casa Grande AZ 85122-4299 Ph: (520) 436-0843 |
| NPI Number | 1144901547 |
|---|---|
| Provider Enumeration Date | 07/27/2023 |
| Last Update Date | 07/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144901547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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