| NPI | 1285191767 |
|---|---|
| Doing Business As | SMILE STORE |
| Entity Type | Organization |
| Authorized Contact | MARTIN BREMER Registered Agent 650-649-9497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2019-02-21 |