| NPI | 1689129637 |
|---|---|
| Doing Business As | MOUNT PROSPECT SMILES |
| Entity Type | Organization |
| Authorized Contact | AVANTI SANGHAVI Officer 857-544-2482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.028622) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2016-08-19 |