South Bend Smiles Youth Dentistry, LLC

NPI #1902017593 in Mishawaka, Indiana

Provider Information

NPI Number
1902017593
Entity Type
Organization
Organization Name
South Bend Smiles Youth Dentistry, LLC
Primary Specialty
Dentist - General Practice
Enumeration Date
May 24, 2007
Last Updated
Jul 9, 2014

Practice Location

Address
2332 MIRACLE LN
State
Indiana
ZIP Code
46545-3012
Phone
(574) 259-5437

Authorized Official

Name
MRS. JENELL STUMP
Title
MANAGER, LICENSING & CREDENTIALING
Phone
(615) 750-0343

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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