| Smalltown Dental On Fourth Llc | |
|
1600 S 4th Ave Ste 110 Morton IL 61550-3401 | |
| (309) 263-2781 | |
| Not Available |
| Full Name | Smalltown Dental On Fourth Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1600 S 4th Ave Ste 110, Morton, Illinois |
| Authorized Official Name and Position | Luke Overcash (CIO) |
| Authorized Official Contact | 3093705853 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smalltown Dental On Fourth Llc 1600 S 4th Ave Ste 110 Morton IL 61550-3401 Ph: (309) 263-2781 | Smalltown Dental On Fourth Llc 1600 S 4th Ave Ste 110 Morton IL 61550-3401 Ph: (309) 263-2781 |
| NPI Number | 1427775089 |
|---|---|
| Provider Enumeration Date | 10/25/2022 |
| Last Update Date | 10/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427775089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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