Organization
GREAT SMILE DENTAL PLLC
Active
Parent organization
GREAT SMILE DENTAL PLLC
Other names
Great Smile Dental/Henderson, Great Smile Dental PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT SMILE DENTAL PLLC
Authorized official
JACQUELINE MORALES (DISTRICT MANAGER)
(847) 945-1050
Entity
Organization
Contact information
Practice address
2660 WINDMILL PKWY, HENDERSON, NV 89074-3385
(702) 309-0906
(252) 150-0387
Mailing address
720 OSTERMAN AVE STE 304, DEERFIELD, IL 60015-4339
(847) 945-1050
(847) 940-0433
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2020
Last updated
09/16/2020
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