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General NPI Number Information
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NPI Number | 1851295430
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Entity Type | Organization
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Legal Business Name | INDIE SMILES DENTISTRY LLC
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 2100 W MICHIGAN AVE
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City | MIDLAND
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State | TX
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Zip | 79701-5928
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Country | US
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Telephone | 432-683-5601
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 W MICHIGAIN AVE
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City | MIDLAND
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State | TX
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Zip | 79701
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Country | US
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Telephone | 432-683-5601
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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 | DANIEL KADE GROVER
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Credential | DMD
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Telephone | 503-953-2659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | NULL
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