Provider Demographics
NPI:1023779535
Name:SMILE MORE FAMILY DENTAL, LLC
Entity type:Organization
Organization Name:SMILE MORE FAMILY DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-826-2488
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-0188
Mailing Address - Country:US
Mailing Address - Phone:402-826-2488
Mailing Address - Fax:402-826-5190
Practice Address - Street 1:1117 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:NE
Practice Address - Zip Code:68333-2259
Practice Address - Country:US
Practice Address - Phone:402-826-2488
Practice Address - Fax:402-826-5190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty