# SMILES FOR NM KIDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386984466
- **Authorized official:** EBONIE MARIE BOGDAN (BILLIBNG SPECIALIST)
- **Authorized official phone:** (505) 850-3769

## Contact information

- **Practice address:** 8201 GOLF COURSE RD NW, ALBUQUERQUE, NM 87120-5842
- **Practice address phone:** (505) 892-9010
- **Mailing address:** 8201 GOLF COURSE RD NW, ALBUQUERQUE, NM 87120-5842
- **Mailing address phone:** (505) 892-9010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/26/2013
- **Last updated:** 01/06/2014