| NPI | 1427851252 |
|---|---|
| Doing Business As | GLENN SMILE CENTER |
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD TAREQ KHADRA Dentist 401-225-2455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2025-03-28 |