Soda Smiles, INC

NPI #1760888929 in Soda Springs, Idaho

Provider Information

NPI Number: 1760888929
Entity Type: Organization
Organization Name: Soda Smiles, INC
Primary Specialty: Dentist
Enumeration Date: Nov 14, 2014
Last Updated: Nov 14, 2014

Practice Location

Address: 180 S MAIN ST
City: Soda Springs
State: Idaho
ZIP Code: 83276-1441
Phone: (208) 547-2244

Authorized Official

Name: DR. GARY M LEMARR, DMD
Title: PRESIDENT
Phone: (208) 547-2244

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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