Provider Demographics
NPI:1952057150
Name:SMILES OF COLORADO PLLC
Entity Type:Organization
Organization Name:SMILES OF COLORADO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:R
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:208-757-3087
Mailing Address - Street 1:1036 W BAPTIST RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-2402
Mailing Address - Country:US
Mailing Address - Phone:719-445-0490
Mailing Address - Fax:
Practice Address - Street 1:1036 W BAPTIST RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-2402
Practice Address - Country:US
Practice Address - Phone:719-445-0490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty