NPI | 1508208448 |
---|---|
Doing Business As | BEAUTIFUL SMILES BY DESIGN |
Entity Type | Organization |
Authorized Contact | KIM WILSON Credentialing Supervisor 217-540-5170 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2013-07-19 |
Last Update Date | 2013-07-19 |