Provider Demographics
NPI:1508409046
Name:SMILE MORE, SMILE BETTER, LLC
Entity Type:Organization
Organization Name:SMILE MORE, SMILE BETTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MISOOK
Authorized Official - Middle Name:AN
Authorized Official - Last Name:RISSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:417-248-1234
Mailing Address - Street 1:1722 S GLENSTONE AVE STE O
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-1513
Mailing Address - Country:US
Mailing Address - Phone:417-248-1234
Mailing Address - Fax:417-248-1515
Practice Address - Street 1:1722 S GLENSTONE AVE STE O
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1513
Practice Address - Country:US
Practice Address - Phone:417-248-1234
Practice Address - Fax:417-248-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental