Provider Demographics
NPI:1134932825
Name:SMILE FOR-ME PLLC
Entity type:Organization
Organization Name:SMILE FOR-ME PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALIZZA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCERO
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:719-731-1111
Mailing Address - Street 1:8801 ABBEY RD
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-9778
Mailing Address - Country:US
Mailing Address - Phone:719-731-1111
Mailing Address - Fax:
Practice Address - Street 1:8801 ABBEY RD
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-9778
Practice Address - Country:US
Practice Address - Phone:719-731-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental