| NPI | 1134898786 |
|---|---|
| Doing Business As | SMILE CLUB |
| Entity Type | Organization |
| Authorized Contact | ANN BOSON Executive Director 715-343-7209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2021-09-08 |