Provider Demographics
NPI:1013253434
Name:HAPPY SMILES
Entity Type:Organization
Organization Name:HAPPY SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SRIVALLI
Authorized Official - Middle Name:
Authorized Official - Last Name:SANKARANARAYANAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-412-2098
Mailing Address - Street 1:13830 DEXTER ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-6972
Mailing Address - Country:US
Mailing Address - Phone:970-412-2098
Mailing Address - Fax:
Practice Address - Street 1:1122 9TH ST STE 101
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-6413
Practice Address - Country:US
Practice Address - Phone:970-353-5203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty