Organization
BIG SMILES CENTER FOR ORTHODONTIC EXCELLENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY E UDELSON DDS (DOCTOR/OWNER)
(708) 386-5437
Entity
Organization
Contact information
Practice address
346 DOWNING RD, RIVERSIDE, IL 60546-1735
(708) 386-5437
Mailing address
346 DOWNING RD, RIVERSIDE, IL 60546-1735
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
09/08/2013
Last updated
09/08/2013
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