MEDICARE: ALL ABOUT SMILES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3202	AR

General Provider Information

NPI Number	:	1932269628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL ABOUT SMILES

Provider Business Mailing Address
First Line	:	3207 ARAPAHO DRIVE
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758
Country	:	US
Telephone Number	:	479-621-9700
Fax Number	:	479-621-6166

Provider Business Practice Location Address
First Line	:	3207 ARAPAHO DR
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-1363
Country	:	US
Telephone Number	:	479-621-9700
Fax Number	:	479-621-6166

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL A KRUPKA
Credential	:	DDS
Telephone Number	:	479-621-9700

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	10/05/2009

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