NPI | 1376913780 |
---|---|
Doing Business As | SMILES ON DELAWARE |
Entity Type | Organization |
Authorized Contact | KENDRA WALKER Credentialing Coordinator 217-540-8312 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2015-09-28 |
Last Update Date | 2015-09-28 |