| Smile Three Professionals | |
|
9990 W 26th Ave Garden Level Lakewood CO 80215-1581 | |
| (303) 202-0880 | |
| Not Available |
| Full Name | Smile Three Professionals |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 9990 W 26th Ave, Lakewood, Colorado |
| Authorized Official Name and Position | Brian James Diemer (OWNER) |
| Authorized Official Contact | 3032020880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Three Professionals 9990 W 26th Ave Garden Level Lakewood CO 80215-1581 Ph: (303) 202-0880 | Smile Three Professionals 9990 W 26th Ave Garden Level Lakewood CO 80215-1581 Ph: (303) 202-0880 |
| NPI Number | 1649715897 |
|---|---|
| Provider Enumeration Date | 12/27/2016 |
| Last Update Date | 12/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649715897 | NPI | - | NPPES |
| 97109053 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D10220 (Colorado) | Primary |
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