Provider Demographics
NPI:1093054579
Name:SMILE MATTERS INC.
Entity Type:Organization
Organization Name:SMILE MATTERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUAIDOO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:800-979-4189
Mailing Address - Street 1:4957 LAKEMONT BLVD SE STE C416
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-7801
Mailing Address - Country:US
Mailing Address - Phone:800-979-4189
Mailing Address - Fax:425-278-7094
Practice Address - Street 1:509 OLIVE WAY
Practice Address - Street 2:SUITE 1033
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1720
Practice Address - Country:US
Practice Address - Phone:800-979-4189
Practice Address - Fax:425-278-7094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6386261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1091650Medicaid
WA6386OtherWA STATE DENTAL LICENSE #
WA6386OtherWA STATE DENTAL LICENSE #