Provider Demographics
NPI:1457246258
Name:SMILE STUDIO DENTAL
Entity type:Organization
Organization Name:SMILE STUDIO DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:N
Authorized Official - Last Name:MORTENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-617-1499
Mailing Address - Street 1:8801 E MONTVIEW BLVD UNIT 120
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-4284
Mailing Address - Country:US
Mailing Address - Phone:720-617-1499
Mailing Address - Fax:720-617-1495
Practice Address - Street 1:8801 E MONTVIEW BLVD UNIT 120
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-4284
Practice Address - Country:US
Practice Address - Phone:720-617-1499
Practice Address - Fax:720-617-1495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental