Provider Demographics
NPI:1891396776
Name:HAPPY HEALTHY SMILES LLC
Entity Type:Organization
Organization Name:HAPPY HEALTHY SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:JAMESON
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:253-929-9065
Mailing Address - Street 1:141 PRELUDE DR
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28574-8477
Mailing Address - Country:US
Mailing Address - Phone:253-929-9065
Mailing Address - Fax:
Practice Address - Street 1:1436 S EDGEWATER CIR
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-5051
Practice Address - Country:US
Practice Address - Phone:208-463-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
1942791454OtherDENTIST