Big Smiles Center for Orthodontic Excellence LLC

Organization Active NPI Health Maintenance Organization · Riverside, IL

NPI 1689009797 · NPPES record last updated Sep 8, 2013

Key facts

NPI
1689009797
Entity type
Organization (NPI type 2)
Primary specialty
Health Maintenance Organization 302R00000X
Legal business name
BIG SMILES CENTER FOR ORTHODONTIC EXCELLENCE LLC
Practice address
346 Downing Rd
Riverside, IL 60546-1735
Phone
(708) 386-5437
NPI assigned
Sep 8, 2013
Organization subpart
No

Authorized official

Name
Jerry E Udelson, DDS
Title
Doctor/Owner
Phone
(708) 386-5437

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Yes

Addresses

Primary practice location

346 Downing Rd
Riverside, IL 60546-1735

Mailing address

346 Downing Rd
Riverside, IL 60546-1735

Other providers in Riverside, IL

All providers in Riverside, IL · Health Maintenance Organization in Illinois

Sources for this page

Verify at the official NPI Registry.