# SMILES 4 KIDS PC

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

## Provider details

- **NPI number:** 1467715508
- **Authorized official:** JUSTIN VANBIBBER (OWNER)
- **Authorized official phone:** (801) 231-6682

## Contact information

- **Practice address:** 1148 72ND ST E, SUITE B, TACOMA, WA 98404-1705
- **Practice address phone:** (801) 819-3666
- **Mailing address:** 1148 72ND ST E, SUITE B, TACOMA, WA 98404-1705
- **Mailing address phone:** (801) 819-3666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE60282727 | WA | Yes |

## Other

- **Enumeration date:** 06/22/2012
- **Last updated:** 06/22/2012