Provider Demographics
NPI:1467920694
Name:SNOW FAMILY SMILES LLC
Entity Type:Organization
Organization Name:SNOW FAMILY SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DALLIN
Authorized Official - Middle Name:REED
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-982-7289
Mailing Address - Street 1:7522 E ONZA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-9748
Mailing Address - Country:US
Mailing Address - Phone:480-272-5308
Mailing Address - Fax:
Practice Address - Street 1:4540 E BASELINE RD STE 110
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4616
Practice Address - Country:US
Practice Address - Phone:480-982-7289
Practice Address - Fax:480-983-5295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental