| NPI | 1124478375 |
|---|---|
| Doing Business As | BIG GRIN DENTAL |
| Entity Type | Organization |
| Authorized Contact | NISHA LIZ JOHN President 803-446-2831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 28575) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2016-06-20 |