National Provider Identifier Database

THE SMILE FACTORY MOBILE CLINIC LLC
Dental


Contact Information

THE SMILE FACTORY MOBILE CLINIC LLC
1040 CARLYLE AVE STE 2A
BELLEVILLE, IL62221-5533
Phone: 618-606-7824
Fax:
Website:
Specialty Taxonomy Code
* Dental 261QD0000X
Dental Public Health 1223D0001X

* Indicates primary specialty

NPI Profile & details for THE SMILE FACTORY MOBILE CLINIC LLC

NPI Number 1871369298
Legal business name
LBN
THE SMILE FACTORY MOBILE CLINIC LLC
Authorized official SHERONTA JOHNSON - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 11/27/2023
Last updated 11/27/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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