Provider Demographics
NPI:1760013932
Name:SIMPLY SMILES FAMILY DENTAL, RICHARD ALVAREZ, DDS, LLC
Entity Type:Organization
Organization Name:SIMPLY SMILES FAMILY DENTAL, RICHARD ALVAREZ, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:417-732-6785
Mailing Address - Street 1:183 ROYAL DORNOCH DR
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-7414
Mailing Address - Country:US
Mailing Address - Phone:417-320-1043
Mailing Address - Fax:
Practice Address - Street 1:1093 US HIGHWAY 60 E
Practice Address - Street 2:
Practice Address - City:REPUBLIC
Practice Address - State:MO
Practice Address - Zip Code:65738-1570
Practice Address - Country:US
Practice Address - Phone:417-732-6785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental