Provider Demographics
NPI:1013347012
Name:BOERNE'S LITTLE SMILES DENTISTRY FOR CHILDREN, PLLC
Entity Type:Organization
Organization Name:BOERNE'S LITTLE SMILES DENTISTRY FOR CHILDREN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:830-249-9888
Mailing Address - Street 1:415 S SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2519
Mailing Address - Country:US
Mailing Address - Phone:830-249-9888
Mailing Address - Fax:830-249-7919
Practice Address - Street 1:415 S SCHOOL ST
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2519
Practice Address - Country:US
Practice Address - Phone:830-249-9888
Practice Address - Fax:830-249-7919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty