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General NPI Number Information
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NPI Number | 1376259291
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Entity Type | Organization
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Legal Business Name | SMILE GALAXY DENTAL PLLC
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 2100 N URSULA ST UNIT 425
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City | AURORA
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State | CO
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Zip | 80045-7412
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Country | US
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Telephone | 720-277-2507
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 N URSULA ST UNIT 425
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City | AURORA
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State | CO
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Zip | 80045-7412
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Country | US
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Telephone | 720-277-2507
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HASAN M ALBALWAH
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Credential | DMD
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Telephone | 720-277-2507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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