| NPI | 1306158365 |
|---|---|
| Doing Business As | SMILES ON OCOTILLO |
| Entity Type | Organization |
| Authorized Contact | KAM SHICK Insurance Coordinator 217-540-5141 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR D5769) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2010-07-07 |