| NPI | 1821866153 |
|---|---|
| Former Legal Business Name | THE SMILE MISSION WEST ORLANDO PLLC |
| Entity Type | Organization |
| Authorized Contact | DUSTIN PFUNDHELLER Manager 786-701-8246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-12-15 |
| Last Update Date | 2023-12-15 |