| NPI | 1770244972 |
|---|---|
| Doing Business As | JOLLY SMILES DENTAL |
| Entity Type | Organization |
| Authorized Contact | ELBERT M. HENDERSON Director 586-873-1014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2022-06-04 |