Grand Smiles 4, Pllc

NPI #1194690214 in Rockford, Illinois

Provider Information

NPI Number: 1194690214
Entity Type: Organization
Organization Name: Grand Smiles 4, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 8, 2025
Last Updated: Oct 8, 2025

Practice Location

Address: 115 7TH ST
City: Rockford
State: Illinois
ZIP Code: 61104-1249
Phone: (815) 597-7777

Authorized Official

Name: MOHAMED WAHEED, DDS
Title: DENTIST
Phone: (815) 597-7777

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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