| NPI | 1174243018 |
|---|---|
| Former Legal Business Name | SMILES OF MICHIGAN |
| Entity Type | Organization |
| Authorized Contact | LUCILA MARTINEZ-CASTILLO Dentist 517-381-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2022-08-31 |