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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 Specialty Code Provider Type

Dental

261QD0000X
 

Dental Public Health

1223D0001X
Indicates primary specialty

NPI Profile & details for THE SMILE FACTORY MOBILE CLINIC LLC

NPI Number 1871369298
LBN Legal business name THE SMILE FACTORY MOBILE CLINIC LLC
Authorized official SHERONTA JOHNSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/27/2023
Last updated 11/27/2023 - 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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