Provider Demographics
NPI:1174891022
Name:UPWARD SMILES,INC
Entity type:Organization
Organization Name:UPWARD SMILES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-327-8010
Mailing Address - Street 1:2820 ANCHOR DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-7387
Mailing Address - Country:US
Mailing Address - Phone:573-327-8010
Mailing Address - Fax:573-358-5941
Practice Address - Street 1:2820 ANCHOR DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-7387
Practice Address - Country:US
Practice Address - Phone:573-327-8010
Practice Address - Fax:573-358-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty