Provider Demographics
NPI:1639446677
Name:BEST SMILES FAMILY DENTAL, LLC
Entity Type:Organization
Organization Name:BEST SMILES FAMILY DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-877-3900
Mailing Address - Street 1:1300 IROQUOIS AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8553
Mailing Address - Country:US
Mailing Address - Phone:630-877-3900
Mailing Address - Fax:
Practice Address - Street 1:106 19TH AVE
Practice Address - Street 2:SUITE 90
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-3700
Practice Address - Country:US
Practice Address - Phone:630-877-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190195291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty