Organization
SOUTHWEST SMILES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MARIE POVAR RDH (MANAGING MEMBER)
(480) 951-6598
Entity
Organization
Contact information
Practice address
2487 S GILBERT RD STE 105, GILBERT, AZ 85295-2800
(480) 732-1888
Mailing address
11512 E QUEENSBOROUGH AVE, MESA, AZ 85212-4091
(480) 951-6598
(480) 452-1811
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5585
AZ
Other
Enumeration date
08/29/2007
Last updated
08/29/2007
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