Provider Demographics
NPI:1124872643
Name:ALL SMILE BY KAI WILCOTS LLC
Entity type:Organization
Organization Name:ALL SMILE BY KAI WILCOTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAI
Authorized Official - Middle Name:K
Authorized Official - Last Name:WILCOTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-323-6560
Mailing Address - Street 1:11925 CARIBOU AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-7229
Mailing Address - Country:US
Mailing Address - Phone:951-323-6971
Mailing Address - Fax:
Practice Address - Street 1:11001 SPAIN RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-1897
Practice Address - Country:US
Practice Address - Phone:951-323-6560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental