Provider Demographics
NPI:1588311583
Name:KALAMAZOO FAMILY SMILES, PLLC
Entity type:Organization
Organization Name:KALAMAZOO FAMILY SMILES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BANDOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:269-353-3700
Mailing Address - Street 1:5925 VENTURE PARK DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-1859
Mailing Address - Country:US
Mailing Address - Phone:269-353-3700
Mailing Address - Fax:
Practice Address - Street 1:5925 VENTURE PARK DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-1859
Practice Address - Country:US
Practice Address - Phone:269-353-3700
Practice Address - Fax:269-353-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty