| NPI | 1558962795 |
|---|---|
| Doing Business As | SMALLTOWN DENTAL PEORIA |
| Entity Type | Organization |
| Authorized Contact | LUKE OVERCASH Operations Manager 309-370-5853 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |