| Central Illinois Smiles | |
|
3250 N Woodford St Decatur IL 62526-2836 | |
| (217) 877-1742 | |
| Not Available |
| Full Name | Central Illinois Smiles |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3250 N Woodford St, Decatur, Illinois |
| Authorized Official Name and Position | Mary Katherine Booth (OWNER /DENTIST) |
| Authorized Official Contact | 2178771742 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Illinois Smiles 3250 N Woodford St Decatur IL 62526-2836 Ph: (217) 877-1742 | Central Illinois Smiles 3250 N Woodford St Decatur IL 62526-2836 Ph: (217) 877-1742 |
| NPI Number | 1447847843 |
|---|---|
| Provider Enumeration Date | 12/31/2020 |
| Last Update Date | 07/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447847843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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