Healthcare Provider Details

I. General information

NPI: 1831434091
Provider Name (Legal Business Name): HAPPY TEETH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2012
Last Update Date: 11/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 ESTATE ALTONA SUITE 13
ST THOMAS VI
00802-5735
US

IV. Provider business mailing address

3004 ESTATE ALTONA SUITE 13
ST THOMAS VI
00802-5735
US

V. Phone/Fax

Practice location:
  • Phone: 340-776-4537
  • Fax:
Mailing address:
  • Phone: 340-776-4537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1139
License Number StateVI
# 2
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL SCOTT BARROWS
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 340-776-4537