| Vivid Smiles | |
|
2512 Wabash Ave Terre Haute IN 47803-1506 | |
| (888) 988-4066 | |
| Not Available |
| Full Name | Vivid Smiles |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2512 Wabash Ave, Terre Haute, Indiana |
| Authorized Official Name and Position | Brandon Alexander Taylor (CREDENTIALING&PAYERRELATIONSMANAGER) |
| Authorized Official Contact | 8474537396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivid Smiles 2050 E Algonquin Rd Ste 610 Schaumburg IL 60173-4166 Ph: (888) 988-4066 | Vivid Smiles 2512 Wabash Ave Terre Haute IN 47803-1506 Ph: (888) 988-4066 |
| NPI Number | 1619433737 |
|---|---|
| Provider Enumeration Date | 02/13/2019 |
| Last Update Date | 10/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619433737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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