| 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 |