Provider Demographics
NPI:1629435730
Name:CARING SMILES PRACTICE MANAGEMENT
Entity Type:Organization
Organization Name:CARING SMILES PRACTICE MANAGEMENT
Other - Org Name:DENTAL CARE IN MONTROSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-240-2720
Mailing Address - Street 1:1333 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5549
Mailing Address - Country:US
Mailing Address - Phone:970-240-2720
Mailing Address - Fax:970-240-2724
Practice Address - Street 1:1100 E MAIN ST
Practice Address - Street 2:STE D
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4064
Practice Address - Country:US
Practice Address - Phone:970-240-2720
Practice Address - Fax:970-240-2720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00202119122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty