Gary Smiles Youth Dentistry, Llc

LBN: Gary Smiles Youth Dentistry, Llc
Gary Smiles Youth Dentistry, Llc is an health care organization with primary practice located at 3506 Village Ct , Gary IN 46408-1428. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Gary Smiles Youth Dentistry, Llc can be contacted via phone (219) 985-3133, or through Stump, Jenell via phone (615) 750-0343.

Contact Information

Primary practice address
3506 Village Ct Gary IN 46408-1428
Fax: (219) 985-3139
Website:
Authorized official contact:
Name: Stump, Jenell

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1073684247
LBN Legal business name Gary Smiles Youth Dentistry, Llc
DBA Doing business as
Authorized official Stump, Jenell
Entity Organization
Organization subpart 1 No
Enumeration date Nov 10th, 2006
Last updated Jul 9th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073684247 NPPES
Illinois MEDICAID 1073684247
Illinois MEDICAID 200379630A

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