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General NPI Number Information
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NPI Number | 1467399394
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Entity Type | Organization
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Legal Business Name | SMILES ONLY PLLC
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 8878 E TANQUE VERDE RD
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City | TUCSON
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State | AZ
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Zip | 85749-9500
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Country | US
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Telephone | 520-749-1230
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Fax | 520-749-9808
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Provider Business Mailing Address
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Address Line | 8878 E TANQUE VERDE RD
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City | TUCSON
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State | AZ
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Zip | 85749-9500
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Country | US
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Telephone | 520-749-1230
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Fax | 520-749-9808
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Authorized Official
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Title or Position | OWNER
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Name | JOHN DALE VREDENBURG III
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Credential | DMD
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Telephone | 248-808-7109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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