| NPI | 1053706747 |
|---|---|
| Doing Business As | SMILES AT CAROLINA FOREST |
| Entity Type | Organization |
| Authorized Contact | HEATHER PRUEMER Credentialing 217-540-8434 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |