| NPI | 1184185753 |
|---|---|
| Former Legal Business Name | SMILE HARVEST DENTAL |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MANZO SOTOMIL Owner 209-526-1190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2019-08-21 |