| NPI | 1790870012 |
|---|---|
| Other Name | SMILEALIVE |
| Entity Type | Organization |
| Authorized Contact | TERRI LEANNE BAARSTAD President Corporation 541-683-8396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D7914) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |