| NPI | 1114412848 |
|---|---|
| Former Legal Business Name | GORGEOUS SMILE PLLC, PLLC |
| Entity Type | Organization |
| Authorized Contact | AHMED T AL-SALIM Owner 619-278-9239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |