Provider Demographics
NPI:1912025230
Name:AABSOLUTELY SMILES, PC
Entity Type:Organization
Organization Name:AABSOLUTELY SMILES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AAB
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:970-622-0970
Mailing Address - Street 1:1135 N LINCOLN AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-4877
Mailing Address - Country:US
Mailing Address - Phone:970-622-0970
Mailing Address - Fax:
Practice Address - Street 1:1135 N LINCOLN AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4877
Practice Address - Country:US
Practice Address - Phone:970-622-0970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10738061Medicaid