Healthcare Provider Details

I. General information

NPI: 1851245120
Provider Name (Legal Business Name): SMILEPRO ORTHODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2026
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 S 500 W STE 3
PAYSON UT
84651-3205
US

IV. Provider business mailing address

805 S 500 W STE 3
PAYSON UT
84651-3205
US

V. Phone/Fax

Practice location:
  • Phone: 801-430-9300
  • Fax:
Mailing address:
  • Phone: 801-430-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. BENJAMIN HARVEY
Title or Position: ORTHODONTIST
Credential: DDS, MS
Phone: 801-362-0849