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Organization

SMILES 4 KIDS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUSTIN VANBIBBER (OWNER)
(801) 231-6682
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60282727
WA

Other

Enumeration date
06/22/2012
Last updated
06/22/2012
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