NPI | 1316711922 |
---|---|
Doing Business As | SMILE MAKER |
Entity Type | Organization |
Authorized Contact | DMITRY KARAGODSKY Authorized Official, Doctor 215-969-2015 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2023-11-14 |
Last Update Date | 2023-11-14 |