| NPI | 1033381603 |
|---|---|
| Doing Business As | SMILES FOR KIDS |
| Entity Type | Organization |
| Authorized Contact | EBONIE GONZALES Credentialing Manager 505-850-3769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NM DD2829) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NM DD2829) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2022-06-16 |