NPI | 1740308576 |
---|---|
Doing Business As | SMILES ON MAIN |
Entity Type | Organization |
Authorized Contact | KETANKUMAR G PATEL Dentist 678-762-1613 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: GA DN012835) |
Additional Taxonomies | 122300000X Dentist (Licence: GA DN008017) |
122300000X Dentist (Licence: GA DN007359) | |
Enumeration Date | 2007-03-27 |
Last Update Date | 2014-11-13 |