| Little Big Smiles, Llc | |
|
9000 E 350 Raytown MO 64133-5717 | |
| (816) 674-9796 | |
| Not Available |
| Full Name | Little Big Smiles, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9000 E 350, Raytown, Missouri |
| Authorized Official Name and Position | Benjamin G Wilson (OWNER/DENTIST) |
| Authorized Official Contact | 9709019865 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Little Big Smiles, Llc 9000 E 350 Raytown MO 64133-5717 Ph: (816) 674-9796 | Little Big Smiles, Llc 9000 E 350 Raytown MO 64133-5717 Ph: (816) 674-9796 |
| NPI Number | 1609249804 |
|---|---|
| Provider Enumeration Date | 11/10/2015 |
| Last Update Date | 11/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609249804 | NPI | - | NPPES |
| 1790905800 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 2010033385 (Missouri) | Primary |
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