| NPI | 1760030514 |
|---|---|
| Doing Business As | GREAT SMILES |
| Entity Type | Organization |
| Authorized Contact | SHARON GARZA Credentialing Manager 469-706-7057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2019-12-16 |