NPI 1053657809

First Smiles Dental, PC

Organisation Pediatric Dentistry Crystal Lake, IL

Practice location

Address: 278 Memorial Dr Suite B, Crystal Lake, IL 60014-6246
Phone: (815) 455-3110

Authorised official

Name: Scott Goldman
Title: President
Phone: (847) 987-0322

Registered specialties

Pediatric Dentistry Primary

Dental Providers Taxonomy 1223P0221X Licence 019027333 (IL)

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Registry record

NPI: 1053657809
Entity type: Organization
NPI issued: 26 Dec 2012
Record last updated: 26 Dec 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.