Healthcare Provider Details
I. General information
NPI: 1225849839
Provider Name (Legal Business Name): SMILE TO SMILES, L.C.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/15/2025
Last Update Date: 01/15/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8464 S BINGHAM VIEW DR
WEST JORDAN UT
84088-5900
US
IV. Provider business mailing address
8464 S BINGHAM VIEW DR
WEST JORDAN UT
84088-5900
US
V. Phone/Fax
- Phone: 801-759-7728
- Fax:
- Phone: 801-759-7728
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
APRIL
ZAMBRANO
Title or Position: PRESIDENT
Credential: RDH
Phone: 801-759-7728