Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Smalltown Dental Glen LLC

Organization General Practice Dentistry · NPI 1477148179

Smalltown Dental Glen LLC is a General Practice Dentistry in Peoria, Illinois. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2015 W Glen Ave Ste 230
Peoria, IL 61614-4691
Phone: (309) 673-4616
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1477148179
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSmalltown Dental Management LLC
Authorized official Luke Overcash — Operations Manager · (309) 370-5853
NPI enumeratedMarch 4, 2021
Last updated in NPPESMarch 4, 2021
Certification dateMarch 4, 2021
Mailing address1600 S 4th Ave Ste 110, Morton, IL 61550-3401

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