Organization
LODS OF SMILES FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG S LODS DDS (DENTIST)
(740) 703-6689
Entity
Organization
Contact information
Practice address
110 E YORK ST, ROCKVILLE, IN 47872-1732
(740) 703-6689
Mailing address
5101 N BROADWAY AVE, MUNCIE, IN 47303-6300
(740) 703-6689
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326568494
NPI
IN
Enumeration date
10/13/2020
Last updated
10/13/2020
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