NPI | 1013675842 |
---|---|
Doing Business As | PEACE HAVEN SMILES |
Entity Type | Organization |
Authorized Contact | KENITRA RICHARDSON Dentist/Owner/Manager 336-314-8535 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2021-11-29 |
Last Update Date | 2021-11-29 |