Organization
GREAT SMILE DENTAL PLLC
Active
Parent organization
GREAT SMILE DENTAL PLLC
Other names
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
720 OSTERMAN AVE STE 304, DEERFIELD, IL 60015-4339
(847) 945-1050
(847) 940-0433
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
09/16/2020
Last updated
09/16/2020
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