Organization
SMILES 4 KIDS JEROME PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEANN SPORIN (OFFICE MANAGER)
(208) 734-7415
Entity
Organization
Contact information
Practice address
115 EAST ROSE ST., JEROME, ID 83338
(208) 324-7415
Mailing address
PO BOX 6075, TWIN FALLS, ID 83303-6075
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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