| NPI | 1518649516 |
|---|---|
| Doing Business As | SOUTHERN SMILES DENTAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | JEANNINE SASO Business Manager 916-479-3432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2024-02-01 |