Organization
KIDDO SMILES DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHUN WONG (OWNER)
(614) 218-1820
Entity
Organization
Contact information
Practice address
1132 INDEPENDENCE AVE, MARION, OH 43302-6318
(740) 383-3223
(740) 375-0278
Mailing address
1132 INDEPENDENCE AVE, MARION, OH 43302-6318
(740) 383-3223
(740) 375-0278
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
30022603
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2750867
—
OH
Enumeration date
11/17/2016
Last updated
11/17/2016
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