# SMILES 4 KIDS LACEY. PC

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

## Provider details

- **NPI number:** 1982026407
- **Authorized official:** MADISON LEHMAN (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (720) 603-4779

## Contact information

- **Practice address:** 3315 PACIFIC AVENUE SE, SUITE A1, OLIMPIA, WA 98501
- **Practice address phone:** (360) 491-1414
- **Mailing address:** 3315 PACIFIC AVENUE SE, SUITE A1, OLIMPIA, WA 98501
- **Mailing address phone:** (360) 491-1414

## Taxonomy

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

## Other

- **Enumeration date:** 01/17/2014
- **Last updated:** 07/06/2021