| NPI | 1033765870 |
|---|---|
| Other Name | INNOVATIVE SMILES |
| Doing Business As | INNOVATIVE SMILES |
| Entity Type | Organization |
| Authorized Contact | JESMINE BOGHAWALA Dentist 562-860-6626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2019-08-16 |