| NPI | 1366556599 |
|---|---|
| Doing Business As | HOLLYWOOD SMILES |
| Entity Type | Organization |
| Authorized Contact | RICHARD A SQUIRES President 314-352-2127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 11774) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2008-06-25 |