Healthcare Provider Details
I. General information
NPI: 1467372755
Provider Name (Legal Business Name): SMILE DOCTORS OF COLORADO, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11989 HOLLY ST
THORNTON CO
80233-1802
US
IV. Provider business mailing address
PO BOX 674468
DALLAS TX
75267-4468
US
V. Phone/Fax
- Phone: 303-452-7777
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SCOTT
V
LAW
Title or Position: OWNER
Credential: DMD
Phone: 719-252-1860