| NPI | 1609450006 |
|---|---|
| Doing Business As | SMILE DENTAL OF TRACY |
| Entity Type | Organization |
| Authorized Contact | DAVID S PARK Dds/CEO 310-403-1117 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2021-05-12 |