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General NPI Number Information
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NPI Number | 1205054848
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Entity Type | Organization
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Legal Business Name | THE SMILE FACTORY FOR THE CHILDREN OF THE DESERT
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1140 N. INDIAN CANYON DRIVE
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City | PALM SPRINGS
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State | CA
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Zip | 92262
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Country | US
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Telephone | 760-318-2465
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Fax | 760-406-6155
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Provider Business Mailing Address
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Address Line | 100 S. SUNRISE WAY, A-409
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City | PALM SPRINGS
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State | CA
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Zip | 92262-6778
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Country | US
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Telephone | 760-318-2465
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Fax | 760-406-6155
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Authorized Official
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Title or Position | DENTAL DIRECTOR
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Name | RONALD A FRENCH
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Credential | DDS
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Telephone | 760-318-2465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 17680
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License Number State | CA
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