| NPI | 1225308398 |
|---|---|
| Doing Business As | SOUTHERN SMILES |
| Entity Type | Organization |
| Authorized Contact | JENNIFER NEWTON BOLES Owner 318-248-4986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5050) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2023-03-15 |