# KIDDO SMILES DENTAL

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

## Provider details

- **NPI number:** 1568904878
- **Authorized official:** CHUN WONG (OWNER)
- **Authorized official phone:** (614) 218-1820

## Contact information

- **Practice address:** 1132 INDEPENDENCE AVE, MARION, OH 43302-6318
- **Practice address phone:** (740) 383-3223
- **Practice address fax:** (740) 375-0278
- **Mailing address:** 1132 INDEPENDENCE AVE, MARION, OH 43302-6318
- **Mailing address phone:** (740) 383-3223
- **Mailing address fax:** (740) 375-0278

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 30022603 | OH | Yes |

## Other

- **Enumeration date:** 11/17/2016
- **Last updated:** 11/17/2016