| NPI | 1295979847 |
|---|---|
| Doing Business As | SMILE DESIGN STUDIO |
| Entity Type | Organization |
| Authorized Contact | TREVA EILEEN WILLIS Dentist/Member 410-913-1077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 12693) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 14153) |
| 1223P0700X Dentist, Prosthodontics (Licence: MD 12460) | |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |