| NPI | 1528678497 |
|---|---|
| Doing Business As | CUSTOM SMILES DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | PAO CHUA VANG Dentist 763-390-8995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2020-08-05 |