# SOUTHWEST SMILES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013101419
- **Authorized official:** KELLY MARIE POVAR RDH (MANAGING MEMBER)
- **Authorized official phone:** (480) 951-6598

## Contact information

- **Practice address:** 2487 S GILBERT RD STE 105, GILBERT, AZ 85295-2800
- **Practice address phone:** (480) 732-1888
- **Mailing address:** 11512 E QUEENSBOROUGH AVE, MESA, AZ 85212-4091
- **Mailing address phone:** (480) 951-6598
- **Mailing address fax:** (480) 452-1811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 124Q00000X | Dental Hygienist | 5585 | AZ | Yes |

## Other

- **Enumeration date:** 08/29/2007
- **Last updated:** 08/29/2007