| Smilecreator Of Alabama Llc | |
| 
					191 Herren Camp Rd Dadeville AL 36853-6719  | |
| (256) 373-8333 | |
| Not Available | 
| Full Name | Smilecreator Of Alabama Llc | 
|---|---|
| Speciality | Dentist | 
| Location | 191 Herren Camp Rd, Dadeville, Alabama | 
| Authorized Official Name and Position | Nilo Hernandez (DOCTOR/AUTHORIZED OFFICIAL) | 
| Authorized Official Contact | 2563738333 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Smilecreator Of Alabama Llc 191 Herren Camp Rd Dadeville AL 36853-6719 Ph: () -  | Smilecreator Of Alabama Llc 191 Herren Camp Rd Dadeville AL 36853-6719 Ph: (256) 373-8333  | 
| NPI Number | 1952099111 | 
|---|---|
| Provider Enumeration Date | 04/26/2023 | 
| Last Update Date | 04/26/2023 | 
| Medicare PECOS PAC ID | 8628439080 | 
|---|---|
| Medicare Enrollment ID | O20240201002116 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1952099111 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary | 
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary | 
| Provider Name | Nilo A Hernandez | 
|---|---|
| Provider Type | Practitioner - Oral Surgery | 
| Provider Identifiers | NPI Number: 1396748372 PECOS PAC ID: 2264852110 Enrollment ID: I20240304002956  | 
F. Kent Norris D.m.d., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 Mariarden Rd, Dadeville, AL 36853 Phone: 256-825-7853  |