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General NPI Number Information
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NPI Number | 1578733044
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Entity Type | Organization
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Legal Business Name | DESIGNING SMILES LTD.
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 03/11/2008
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Provider Practice Location Address
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Address Line | 225 N MARKET ST
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City | PAXTON
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State | IL
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Zip | 60957-1189
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Country | US
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Telephone | 217-379-4667
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Fax |
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Provider Business Mailing Address
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Address Line | 225 N MARKET ST
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City | PAXTON
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State | IL
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Zip | 60957-1189
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Country | US
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Telephone | 217-379-4667
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. TODD A JOHNSON
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Credential | D.M,D
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Telephone | 217-379-4667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State | IL
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