| All About Smiles LC | |
|
1717 E Cherokee St Suite 104 Springfield MO 65804-2335 | |
| (417) 889-5757 | |
| (417) 889-5758 |
| Full Name | All About Smiles LC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1717 E Cherokee St, Springfield, Missouri |
| Authorized Official Name and Position | Lorin G Van Drie (OWNER) |
| Authorized Official Contact | 4172343305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| All About Smiles LC 1717 E Cherokee St Suite 104 Springfield MO 65804-2335 Ph: (417) 889-5757 | All About Smiles LC 1717 E Cherokee St Suite 104 Springfield MO 65804-2335 Ph: (417) 889-5757 |
| NPI Number | 1184986077 |
|---|---|
| Provider Enumeration Date | 06/15/2012 |
| Last Update Date | 06/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184986077 | NPI | - | NPPES |
| 1841511805 | Medicaid | MO | |
| 1669574935 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 012493 (Missouri) | Primary |
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