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General NPI Number Information
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NPI Number | 1326959610
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Entity Type | Organization
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Legal Business Name | SMILE STUDIO NW, LLC
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 4412 HARBOUR POINTE BLVD SW SUITE 202
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City | MUKILTEO
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State | WA
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Zip | 98275
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Country | US
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Telephone | 425-375-0079
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Fax |
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Provider Business Mailing Address
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Address Line | 4412 HARBOUR POINTE BLVD SW SUITE 202
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City | MUKILTEO
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State | WA
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Zip | 98275
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Country | US
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Telephone | 425-375-0079
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. MATTHEW BRUNER
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Credential | DDS, MS
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Telephone | 425-375-0079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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