| NPI | 1033511084 |
|---|---|
| Doing Business As | AUTHENTIC SMILES |
| Entity Type | Organization |
| Authorized Contact | SHANE EDEN MATT Owner 512-330-9403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2014-09-22 |