| NPI | 1447976857 |
|---|---|
| Doing Business As | COASTAL SMILES |
| Entity Type | Organization |
| Authorized Contact | TYLER FREY Authorized Member 810-845-9695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-10-17 |