| NPI | 1780995159 |
|---|---|
| Doing Business As | SMILES ON SOUTHERN |
| Entity Type | Organization |
| Authorized Contact | CARMEN WOODS Insurance Coordinator 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2014-02-04 |