Organization
GROWING SMILES PEDIATRIC DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARISSE M CORNS D.D.S (PRESIDENT)
(213) 500-6789
Entity
Organization
Contact information
Practice address
1111 CUMBERLAND XING, VALPARAISO, IN 46383-2356
(219) 286-6148
(219) 286-6149
Mailing address
1111 CUMBERLAND XING, VALPARAISO, IN 46383-2356
(219) 286-6148
(219) 286-6149
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12011775A
IN
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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