Great Smiles of Rockford, Ltd

NPI #1538386933 in Rockford, Illinois

Provider Information

NPI Number: 1538386933
Entity Type: Organization
Organization Name: Great Smiles of Rockford, Ltd
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 19, 2007
Last Updated: Sep 27, 2007

Practice Location

Address: 780 N MULFORD RD
City: Rockford
State: Illinois
ZIP Code: 61107-3855
Phone: (815) 395-1600

Authorized Official

Name: DR. JONATHAN NABONG ABIERA, DMD
Title: PRESIDENT
Phone: (815) 395-1600

Specialties & Taxonomy Codes

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

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