Healthcare Provider Details

I. General information

NPI: 1649196726
Provider Name (Legal Business Name): SMALL TOWN SMILES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 MAIN ST
QUINTER KS
67752-9526
US

IV. Provider business mailing address

1329 SCHWALLER AVE
HAYS KS
67601-2241
US

V. Phone/Fax

Practice location:
  • Phone: 573-469-8677
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CALEB BORLAND
Title or Position: PRESIDENT
Credential: DDS
Phone: 573-469-8677