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Organization
SMILE LEAGUE DENTAL
Active
Organization
SMILE LEAGUE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOROLAYO OLUYEMI DMD (DENTIST)
(571) 398-9168
Entity
Organization
Contact information
Practice address
3587 HENNEPIN DR # D, JOLIET, IL 60431-9205
(815) 782-6243
Mailing address
3587 HENNEPIN DR # D, JOLIET, IL 60431-9205
(815) 782-6243
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019031102
IL
1223G0001X
General Practice Dentistry
019031102
IL
261QD0000X
Dental Clinic/Center
Primary
019031102
IL
Other
Enumeration date
03/20/2018
Last updated
03/20/2018
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