| NPI | 1952809576 |
|---|---|
| Other Name | KIDSMILES |
| Entity Type | Organization |
| Authorized Contact | LISBEL DOMINGUEZ Administrator 336-788-5588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 9239) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 8103) |
| 1223G0001X Dentist, General Practice (Licence: NC 7892) | |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2018-09-26 |