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Organization
SMALLTOWN DENTAL HOPEDALE
Active
Organization
SMALLTOWN DENTAL HOPEDALE
Active
Parent organization
SMALLTOWN DENTAL MANAGMENT LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SMALLTOWN DENTAL MANAGMENT LLC
Authorized official
LUKE OVERCASH (OPERATIONS MANAGER)
(309) 370-5853
Entity
Organization
Contact information
Practice address
124 NW MAIN ST, HOPEDALE, IL 61747-7511
(309) 449-3371
Mailing address
PO BOX 303, HOPEDALE, IL 61747-0303
(309) 449-3371
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/02/2019
Last updated
06/29/2020
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