| NPI | 1174081152 |
|---|---|
| Doing Business As | SMILELINE DENTAL AND ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | GIANCARLO TASSARA President 612-720-6723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2019-03-08 |