| NPI | 1962043919 |
|---|---|
| Doing Business As | SMILE SAN CLEMENTE |
| Entity Type | Organization |
| Authorized Contact | SHAHIN MAHALLATI Owner 949-248-7772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2021-11-10 |