| NPI | 1770106411 |
|---|---|
| Doing Business As | THE SMILE HOME |
| Entity Type | Organization |
| Authorized Contact | RICARDO CARLO CARRILLO Dentist 703-341-7769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2020-05-28 |