NPI 1164848750

Smile Experts Dental Associates

Organisation Exclusive Provider Organization Jacksonville, IL

Practice location

Address: 1515 W Walnut St, Jacksonville, IL 62650-1150
Phone: (217) 245-1190
Fax: (217) 291-0401

Authorised official

Name: Sheetal Sharma
Title: Doctor
Phone: (630) 901-7784

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 019028573 (IL)

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Registry record

NPI: 1164848750
Entity type: Organization
NPI issued: 6 Mar 2014
Record last updated: 6 Mar 2014

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.