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General NPI Number Information
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NPI Number | 1972776102
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Entity Type | Organization
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Legal Business Name | SMILE STUDIO ORTHODONTICS
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 05/04/2021
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Provider Practice Location Address
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Address Line | 390 S. DAYTON ST.
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City | DENVER
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State | CO
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Zip | 80247
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Country | US
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Telephone | 720-815-3540
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Fax |
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Provider Business Mailing Address
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Address Line | 10450 S. PROGRESS WAY SUITE 100
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City | PARKER
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State | CO
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Zip | 80134
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Country | US
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Telephone | 720-780-0865
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHAD M. WATTS
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Credential | DMD
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Telephone | 720-780-0865
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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 | 8530
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License Number State | CO
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