Organization
SLD LLC
Active
Other names
Smile Lines Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JARED POPE DDS (CEO)
(480) 332-6111
Entity
Organization
Contact information
Practice address
21300 N JOHN WAYNE PKWY, STE 108, MARICOPA, AZ 85139-8979
(520) 494-7578
Mailing address
4146 NEUMAN RD, SAINT CLAIR, MI 48079-3234
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D05625
AZ
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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