| NPI | 1073247052 |
|---|---|
| Doing Business As | SCUBA SMILES FOR KIDS |
| Entity Type | Organization |
| Authorized Contact | LELA CHRISTINE FARMER Owner 704-641-4117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-07-14 |