Provider Demographics
NPI:1699463497
Name:J & J SMILES
Entity type:Organization
Organization Name:J & J SMILES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAZZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:623-217-2948
Mailing Address - Street 1:12425 W BELL RD
Mailing Address - Street 2:SUITE A-128
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378-9023
Mailing Address - Country:US
Mailing Address - Phone:623-217-2948
Mailing Address - Fax:602-428-6860
Practice Address - Street 1:1175 W WICKENBURG WAY
Practice Address - Street 2:SUITE 1
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-2262
Practice Address - Country:US
Practice Address - Phone:623-217-2948
Practice Address - Fax:602-428-6860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental