# SMILE CRAFT DENTAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Smile Craft Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861014367
- **Authorized official:** CINDY LE (OFFICE MANAGER)
- **Authorized official phone:** (408) 209-2855

## Contact information

- **Practice address:** 5315 E 21ST ST N STE 104, WICHITA, KS 67208-1600
- **Practice address phone:** (408) 209-2855
- **Mailing address:** 5315 E 21ST ST N STE 104, WICHITA, KS 67208-1600
- **Mailing address phone:** (408) 209-2855

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 05/07/2020
- **Last updated:** 05/07/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200877840C | — | KS |