Provider Demographics
NPI:1205132404
Name:ALL SMILES FAMILY DENTISTRY INC
Entity type:Organization
Organization Name:ALL SMILES FAMILY DENTISTRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONER
Authorized Official - Prefix:
Authorized Official - First Name:TUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-288-0039
Mailing Address - Street 1:445 E 4500 S STE 150
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3101
Mailing Address - Country:US
Mailing Address - Phone:801-288-0039
Mailing Address - Fax:801-288-0096
Practice Address - Street 1:445 E 4500 S STE 150
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-3101
Practice Address - Country:US
Practice Address - Phone:801-288-0039
Practice Address - Fax:801-288-0096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty