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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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- Amy Bilow
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- Amanda Susan Boo
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All providers in Riverside, IL · Health Maintenance Organization in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.