| NPI | 1972727519 |
|---|---|
| Doing Business As | SMILE STORE |
| Entity Type | Organization |
| Authorized Contact | CHARLES M BLUM Owner 713-523-2328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 6636) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-08-22 |