Healthcare Provider Details

I. General information

NPI: 1982164265
Provider Name (Legal Business Name): SMILES TO YOU, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 03/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40330 CAMINO CAMPOS VERDE
TEMECULA CA
92591-6170
US

IV. Provider business mailing address

PO BOX 1013
TEMECULA CA
92593-1013
US

V. Phone/Fax

Practice location:
  • Phone: 951-541-1206
  • Fax: 951-506-2848
Mailing address:
  • Phone: 951-541-1206
  • Fax: 951-506-2848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ORIETTA M. BARRERA
Title or Position: PRESIDENT
Credential: RDHAP
Phone: 951-541-1206