University Smiles LLC

NPI #1902414436 in Lebanon, Illinois

Provider Information

NPI Number: 1902414436
Entity Type: Organization
Organization Name: University Smiles LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 21, 2020
Last Updated: Jul 21, 2020

Practice Location

Address: 229 W SAINT LOUIS ST # SR
City: Lebanon
State: Illinois
ZIP Code: 62254-1515
Phone: (618) 304-5988

Authorized Official

Name: DR. GENA FARRIS PINEDA, DDS
Title: OWNER/DENTIST
Phone: (618) 304-5988

Specialties & Taxonomy Codes

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

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