Smalltown Dental Morton LLC

NPI #1720626906 in Morton, Illinois

Provider Information

NPI Number: 1720626906
Entity Type: Organization
Organization Name: Smalltown Dental Morton LLC
Subpart: Yes (part of a larger organization)
Parent Organization: SMALLTOWN DENTAL MANAGMENT LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 18, 2019
Last Updated: Dec 18, 2019

Practice Location

Address: 134 DETROIT AVE
City: Morton
State: Illinois
ZIP Code: 61550-1532
Phone: (309) 263-7449

Authorized Official

Name: LUKE OVERCASH
Title: OPERATIONS MANAGER
Phone: (309) 370-5853

Specialties & Taxonomy Codes

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

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