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 |