Provider Demographics
NPI:1801354329
Name:BIG WIDE SMILES LLC
Entity type:Organization
Organization Name:BIG WIDE SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LUNSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:413-540-9500
Mailing Address - Street 1:32 WILLIMANSETT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075-3062
Mailing Address - Country:US
Mailing Address - Phone:413-540-9500
Mailing Address - Fax:413-540-9505
Practice Address - Street 1:32 WILLIMANSETT ST
Practice Address - Street 2:
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075-3062
Practice Address - Country:US
Practice Address - Phone:413-540-9500
Practice Address - Fax:413-540-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental