| NPI | 1407407893 |
|---|---|
| Doing Business As | SMILE SQUAD |
| Entity Type | Organization |
| Authorized Contact | AMANDA NAVARRO Credentialing Consultant 832-689-6311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2019-09-26 |