| NPI | 1194592717 |
|---|---|
| Doing Business As | SUPER SMILES 4 KIDS |
| Entity Type | Organization |
| Authorized Contact | BRENDON PRESTWICH President 505-358-8681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-12-04 |
| Last Update Date | 2023-12-04 |