| NPI | 1376316752 |
|---|---|
| Doing Business As | BOULEVARD SMILES |
| Entity Type | Organization |
| Authorized Contact | RAFY LUQA Owner/Dentist 804-229-7613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-11-06 |