| NPI | 1639735178 |
|---|---|
| Doing Business As | SMILE SHOP |
| Entity Type | Organization |
| Authorized Contact | MAHMOUD AHMAD Owner 507-413-2016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2019-05-09 |