| NPI | 1467291559 |
|---|---|
| Former Legal Business Name | SMILE BAR LLC |
| Entity Type | Organization |
| Authorized Contact | TARA MARIE BONNEAU CEO 303-808-7722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-05-20 |