Organization
SMILE 4 LIFE, P.C.
Active
Parent organization
SMILE 4 LIFE, P.C.
Other names
Smile 4 Life Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
SMILE 4 LIFE, P.C.
Authorized official
JENNIE MACUMBER R.D.H. (PRESIDENT)
(303) 829-9243
Entity
Organization
Contact information
Practice address
12253 E 104TH PLACE, SUITE 105, COMMERCE CITY, CO 80022
(303) 853-8000
(303) 288-2219
Mailing address
12253 E 104TH PLACE, SUITE 105, COMMERCE CITY, CO 80022
(303) 853-8000
(303) 288-2219
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
124Q00000X
Dental Hygienist
903823
CO
Other
Enumeration date
08/14/2009
Last updated
05/12/2017
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