Provider Demographics
NPI:1427491802
Name:LAKEWOOD SMILES, P.C.
Entity type:Organization
Organization Name:LAKEWOOD SMILES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCALA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-988-6860
Mailing Address - Street 1:10815 W JEWELL AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-4851
Mailing Address - Country:US
Mailing Address - Phone:303-988-6860
Mailing Address - Fax:303-988-3274
Practice Address - Street 1:10815 W JEWELL AVE STE L
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6268
Practice Address - Country:US
Practice Address - Phone:303-988-6860
Practice Address - Fax:303-988-3274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN9509261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental