| NPI | 1346516929 |
|---|---|
| Doing Business As | SMILES 4 KIDS |
| Entity Type | Organization |
| Authorized Contact | J RYAN MICKELSON President 970-247-0174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 8630) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |