| NPI | 1104141316 |
|---|---|
| Doing Business As | ELITE SMILES |
| Entity Type | Organization |
| Authorized Contact | HENRY C SCHUPPERT President 949-863-9620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 54324) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2010-03-30 |