| NPI | 1548509508 |
|---|---|
| Doing Business As | PROVIDENCE DENTAL HEALTH & WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | LATONIA SMITH Owner 972-641-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2013-02-11 |
| Last Update Date | 2013-02-11 |