| NPI | 1043825078 |
|---|---|
| Doing Business As | GREAT SMILE DENTAL/HENDERSON |
| Other Name | GREAT SMILE DENTAL PLLC |
| Entity Type | Organization |
| Authorized Contact | JACQUELINE MORALES District Manager 847-945-1050 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-16 |