| NPI | 1053883603 |
|---|---|
| Doing Business As | VICTORY SMILES LA PORTE |
| Entity Type | Organization |
| Authorized Contact | JOHN LE Office Manager 832-460-5657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2018-12-20 |