Provider Demographics
NPI:1831434091
Name:HAPPY TEETH CORPORATION
Entity type:Organization
Organization Name:HAPPY TEETH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BARROWS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:340-776-4537
Mailing Address - Street 1:3004 ESTATE ALTONA
Mailing Address - Street 2:SUITE 13
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-5735
Mailing Address - Country:US
Mailing Address - Phone:340-776-4537
Mailing Address - Fax:
Practice Address - Street 1:3004 ESTATE ALTONA
Practice Address - Street 2:SUITE 13
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-5735
Practice Address - Country:US
Practice Address - Phone:340-776-4537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
126800000X
VI1139122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty