SOUTH BEND SMILES YOUTH DENTISTRY, LLC is a general practice dentist in Mishawaka, IN. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. SOUTH BEND SMILES YOUTH DENTISTRY, LLC NPI is 1902017593. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
2332 MIRACLE LN
MISHAWAKA, IN
ZIP 46545-012
Phone: (574) 259-5437
Fax: (574) 259-5438
The provider's authorized official is Jenell Stump .
The authorized official title is Manager, Licensing & Credentialing and has the following contact phone number (615) 750-0343.
The CLIA number assigned to this NPI record is 15D2010516 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 5/24/2007 and was last updated on 7/9/2014.