Organization · Type 2 NPI

Smalltown Dental Willow Knolls LLC

General Practice Dentistry · Peoria, IL

NPI number 1699365809 Active

Practice location

6712 N Mountello Dr
Peoria, IL 61614-2328

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: 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.

3 other providers at this address

Other general practice dentistry providers in Peoria

See all in Peoria →

NPI record

NPI: 1699365809
Entity type: Organization (Type 2)
Issued: Jan 21, 2021
Last updated: Jan 21, 2021
Status: Active
Subpart: Yes of Smalltown Dental Management LLC

Other names

Smalltown Dental Willow Knolls · doing business as

Authorized official

Luke Overcash
Operations Manager
(309) 370-5853

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1699365809

Smalltown Dental Willow Knolls LLC's National Provider Identifier is 1699365809, issued on Jan 21, 2021. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Peoria, IL. The record was last updated on Jan 21, 2021.