CREATE-A-SMILE, PC

BLOOMINGTON, IN
NPI1588995229
Entity TypeOrganization
Authorized ContactSHANNON KENNETH MOORE
Owner
812-332-1405
Organization Subpart ?No
Primary Taxonomy122300000X Dentist
(Licence: IN  12010311A)
Additional Taxonomies122300000X Dentist
(Licence: IN  12011246A)
332B00000X Durable Medical Equipment & Medical Supplies
Enumeration Date2010-01-20
Last Update Date2022-05-17
Business Address
CREATE-A-SMILE, PC
2815 N WALNUT ST
BLOOMINGTON, IN 47404-2077
Phone number: 812-332-1405
Mailing Address
CREATE-A-SMILE, PC
2815 N WALNUT ST
BLOOMINGTON, IN 47404-2077
Phone number: 812-332-1405