Organization
SMILE THREE PROFESSIONALS
Active
Organization
SMILE THREE PROFESSIONALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN JAMES DIEMER DMD,MS (OWNER)
(303) 202-0880
Entity
Organization
Contact information
Practice address
9990 W 26TH AVE, GARDEN LEVEL, LAKEWOOD, CO 80215-1581
(303) 202-0880
Mailing address
9990 W 26TH AVE, GARDEN LEVEL, LAKEWOOD, CO 80215-1581
(303) 202-0880
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D10220
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
97109053
—
CO
Enumeration date
12/27/2016
Last updated
12/27/2016
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