Organization
ALL ABOUT SMILES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUPRENA L CRAWFORD RDH (OWNER)
(970) 819-0370
Entity
Organization
Contact information
Practice address
620 D RED TABLE DR, GYPSUM, CO 81637
(970) 819-0370
(970) 524-1107
Mailing address
620 D RED TABLE DR, GYPSUM, CO 81637
(970) 819-0370
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
904264
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28720067
—
CO
Enumeration date
05/18/2016
Last updated
05/18/2016
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