| Countrywide Smiles P.c. | |
|
110 S State St Annawan IL 61234-9716 | |
| (309) 935-6126 | |
| Not Available |
| Full Name | Countrywide Smiles P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 110 S State St, Annawan, Illinois |
| Authorized Official Name and Position | Bogdan Mihai Taran (PRESIDENT) |
| Authorized Official Contact | 7737336344 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Countrywide Smiles P.c. 501 Dodge St Kewanee IL 61443-3258 Ph: (773) 733-6344 | Countrywide Smiles P.c. 110 S State St Annawan IL 61234-9716 Ph: (309) 935-6126 |
| NPI Number | 1598197105 |
|---|---|
| Provider Enumeration Date | 08/06/2013 |
| Last Update Date | 08/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598197105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019027941 (Illinois) | Primary |