Organization
SMILE STRAIGHT ORTHODONTICS - JACKSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA ZWICKY (MGR)
(480) 866-8811
Entity
Organization
Contact information
Practice address
7040 OLD CANTON RD, RIDGELAND, MS 39157-1035
(601) 368-6635
Mailing address
5717 E THOMAS RD STE 100, SCOTTSDALE, AZ 85251-7620
(480) 866-8811
(602) 429-8200
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
11/03/2021
Last updated
11/03/2021
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