| NPI | 1215364427 |
|---|---|
| Doing Business As | MODERN SMILES DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ALLISON VARNER Insurance/Credentialing 217-540-6077 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN20330) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2013-10-02 |