| Great Smiles Dentistry, Llc | |
|
1656 30th St Boulder CO 80301-1014 | |
| (303) 444-4922 | |
| Not Available |
| Full Name | Great Smiles Dentistry, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1656 30th St, Boulder, Colorado |
| Authorized Official Name and Position | Maya Q Turner (COO) |
| Authorized Official Contact | 3035420288 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Smiles Dentistry, Llc 2525 Arapahoe Ave Ste E4-907 Boulder CO 80302-6720 Ph: (303) 542-0288 | Great Smiles Dentistry, Llc 1656 30th St Boulder CO 80301-1014 Ph: (303) 444-4922 |
| NPI Number | 1649733585 |
|---|---|
| Provider Enumeration Date | 04/08/2019 |
| Last Update Date | 04/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649733585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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