Organization
SMALLTOWN DENTAL KIDS LLC
Active
Parent organization
SMALLTOWN DENTAL MANAGEMENT LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SMALLTOWN DENTAL MANAGEMENT LLC
Authorized official
LUKE OVERCASH (OPERATIONS MANAGER)
(309) 370-5853
Entity
Organization
Contact information
Practice address
1600 S 4TH AVE STE 120, MORTON, IL 61550-3401
(309) 263-2781
Mailing address
1600 S 4TH AVE STE 120, MORTON, IL 61550-3401
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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