| NPI | 1841863248 |
|---|---|
| Doing Business As | THE SMILE ACADEMY |
| Entity Type | Organization |
| Authorized Contact | MOLLY CANTINE Billing Representative 307-635-9251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2021-07-22 |