Provider Demographics
NPI:1275767303
Name:SMILE THREE PROFESSIONALS
Entity Type:Organization
Organization Name:SMILE THREE PROFESSIONALS
Other - Org Name:COMFORT DENTAL BRACES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BAHR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-432-9773
Mailing Address - Street 1:9990 W 26TH AVE
Mailing Address - Street 2:GARDEN LEVEL
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-1581
Mailing Address - Country:US
Mailing Address - Phone:303-202-0880
Mailing Address - Fax:303-202-0882
Practice Address - Street 1:9990 W 26TH AVE
Practice Address - Street 2:GARDEN LEVEL
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-1581
Practice Address - Country:US
Practice Address - Phone:303-202-0880
Practice Address - Fax:303-202-0882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty