Provider Demographics
NPI:1972848448
Name:GREAT SMILES LTD.
Entity Type:Organization
Organization Name:GREAT SMILES LTD.
Other - Org Name:GREAT SMILES OF PARKER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:BEABER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-465-4487
Mailing Address - Street 1:17021 LINCOLN AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3146
Mailing Address - Country:US
Mailing Address - Phone:303-465-4487
Mailing Address - Fax:303-694-1911
Practice Address - Street 1:17021 E LINCOLN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:303-694-1711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-10
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO87271223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty