MEDICARE: SMILE SOLUTIONS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1811162605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMILE SOLUTIONS INC

Provider Business Mailing Address
First Line	:	8217 WICKER AVE
Second Line	:
City	:	SAINT JOHN
State	:	IN
Zip	:	46373-8878
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8217 WICKER AVE
Second Line	:
City	:	SAINT JOHN
State	:	IN
Zip	:	46373-8878
Country	:	US
Telephone Number	:	219-558-8326
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DANIEL MICHAEL BADE
Credential	:
Telephone Number	:	219-558-8326

Provider Enumeration Date	:	04/23/2008
Last Update Date	:	04/23/2008

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Directions to “SMILE SOLUTIONS INC ” Practice Location

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