| NPI | 1235540253 |
|---|---|
| Doing Business As | GREAT EXPRESSION SMILES |
| Entity Type | Organization |
| Authorized Contact | TRI PHAM President 817-496-2343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-05-13 |