| NPI | 1871369298 |
|---|---|
| Doing Business As | THE SMILE FACTORY MOBILE CLINIC LLC |
| Entity Type | Organization |
| Authorized Contact | SHERONTA JOHNSON Owner 618-606-7824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2023-11-27 |