| NPI | 1376250415 |
|---|---|
| Doing Business As | MY NEW SMILE |
| Entity Type | Organization |
| Authorized Contact | HALEY WOOSTER Enrollment Specialist 712-733-8551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-10-28 |
| Last Update Date | 2022-10-28 |