| NPI | 1790191377 |
|---|---|
| Doing Business As | GRAND SMILE DENTAL |
| Entity Type | Organization |
| Authorized Contact | ANGUEL HRISTOV PANEV Dentist 718-218-9494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 050701) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2014-07-03 |