NPI | 1093057556 |
---|---|
Doing Business As | SKYLINE SMILES |
Entity Type | Organization |
Authorized Contact | DEEPAK JOSEPH NEDUVELIL Owner 612-710-3883 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027964) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019027966) |
Enumeration Date | 2013-03-22 |
Last Update Date | 2013-03-22 |