| NPI | 1154187920 |
|---|---|
| Doing Business As | CLEMMONS VILLAGE SMILES |
| Entity Type | Organization |
| Authorized Contact | MATTHEW KOSTELIC Owner/Manager 336-577-1583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-02-28 |
| Last Update Date | 2024-03-05 |