Provider Demographics
NPI:1760951818
Name:ALWAYS GREAT SMILES DOT COM PC
Entity Type:Organization
Organization Name:ALWAYS GREAT SMILES DOT COM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-469-0296
Mailing Address - Street 1:586 DUANE ST STE 301
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-4639
Mailing Address - Country:US
Mailing Address - Phone:630-545-9155
Mailing Address - Fax:
Practice Address - Street 1:586 DUANE ST
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-4639
Practice Address - Country:US
Practice Address - Phone:630-469-0296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment