# SMILE INNOVATIONS CORP

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

## Provider details

- **NPI number:** 1629243571
- **Authorized official:** DR. BOYD PATUMMAS D.M.D (DENTIST/VICE PRESIDENT)
- **Authorized official phone:** (480) 820-7777

## Contact information

- **Practice address:** 6323 S RURAL RD STE 101, TEMPE, AZ 85283-2933
- **Practice address phone:** (480) 820-7777
- **Practice address fax:** (480) 820-7774
- **Mailing address:** 6323 S RURAL RD STE 101, TEMPE, AZ 85283-2933
- **Mailing address phone:** (480) 820-7777
- **Mailing address fax:** (480) 820-7774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 04/22/2008
- **Last updated:** 08/12/2024