# HEALTHY SMILES MOBILE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255626826
- **Authorized official:** GAIL A LUSK (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (813) 221-4038

## Contact information

- **Practice address:** 16409 E 38TH ST CT S, INDEPENDENCE, MO 64055
- **Practice address phone:** (816) 427-1164
- **Practice address fax:** (816) 535-2184
- **Mailing address:** 16409 E 38TH ST CT S, INDEPENDENCE, MO 64055
- **Mailing address phone:** (816) 463-2263
- **Mailing address fax:** (816) 463-2264

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | — | NULL | Yes |
| 1223D0001X | Public Health Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/12/2011
- **Last updated:** 10/17/2023