| NPI | 1720398118 |
|---|---|
| Former Legal Business Name | SMALL SMILES DENTAL CENTER OF MUNCIE LLC |
| Entity Type | Organization |
| Authorized Contact | TERESA ANN NICHOLSON Owner/Dentist 260-824-2811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2021-05-14 |