MISSOURI SMILES LLC; NPI #1508549130

Contact Information

MISSOURI SMILES LLC

3621 DISCOVERY PARKWAY
STE 101
COLUMBIA, MO 65201

Phone: 573-424-2067
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Dental	261QD0000X

Indicates primary specialty

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NPI Profile & details for MISSOURI SMILES LLC

NPI #	`1508549130`
LBN Legal business name	MISSOURI SMILES LLC
Authorized official	KYLE LISENBY - (DENTIST OWNER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	08/10/2023
Last updated	08/10/2023 - About 3 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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