Ten Mile Smiles INC

NPI #1598115644 in Meridian, Idaho

Provider Information

NPI Number: 1598115644
Entity Type: Organization
Organization Name: Ten Mile Smiles INC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 20, 2016
Last Updated: Jun 20, 2016

Practice Location

Address: 2700 W CHERRY LN
Address 2: STE 120
City: Meridian
State: Idaho
ZIP Code: 83642-1500
Phone: (208) 887-9000

Authorized Official

Name: WARREN R WILLIS, DMD
Title: PRESIDENT
Phone: (208) 887-9000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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