Provider Demographics
NPI:1457917163
Name:ALL SMILES MUNSTER
Entity Type:Organization
Organization Name:ALL SMILES MUNSTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENIST
Authorized Official - Prefix:
Authorized Official - First Name:BUNMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEKUGBE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:617-308-9291
Mailing Address - Street 1:8933 WHITE OAK AVE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-3134
Mailing Address - Country:US
Mailing Address - Phone:219-838-7703
Mailing Address - Fax:219-838-7797
Practice Address - Street 1:8933 WHITE OAK AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3134
Practice Address - Country:US
Practice Address - Phone:219-838-7703
Practice Address - Fax:219-838-7797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental