# BOULDER SMILES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Boulder smiles
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891423208
- **Authorized official:** DR. ALEXANDRIA BALICH DDS (GENERAL DENTIST)
- **Authorized official phone:** (720) 546-3575

## Contact information

- **Practice address:** 1636 16TH ST, BOULDER, CO 80302-6356
- **Practice address phone:** (303) 443-4417
- **Practice address fax:** (303) 443-1206
- **Mailing address:** 1636 16TH ST, BOULDER, CO 80302-6356
- **Mailing address phone:** (720) 546-3575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/12/2022
- **Last updated:** 09/07/2022