| NPI | 1558034132 |
|---|---|
| Doing Business As | PORTOLA SMILES |
| Entity Type | Organization |
| Authorized Contact | FRANCINE ABAD President 415-468-3756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2021-07-29 |