# LISBON DENTISTRY PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LISBON SMILES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154801090
- **Authorized official:** JENNIFER MARIE LOURENS (OFFICE MANAGER)
- **Authorized official phone:** (701) 683-7695

## Contact information

- **Practice address:** 420 MAIN ST, LISBON, ND 58054-4142
- **Practice address phone:** (701) 683-7695
- **Practice address fax:** (701) 683-7698
- **Mailing address:** PO BOX 1078, LISBON, ND 58054-1078
- **Mailing address phone:** (701) 683-7695

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 1948 | ND | Yes |

## Other

- **Enumeration date:** 08/20/2018
- **Last updated:** 08/20/2018