| NPI | 1023595881 |
|---|---|
| Doing Business As | SENIOR SMILES |
| Entity Type | Organization |
| Authorized Contact | RICHARD F DEST Member/Organizer 704-737-3133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2018-07-25 |