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Organization
KAIBAB PC
Active
Organization
KAIBAB PC
Active
Other names
ALL SMILES DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
BRIELLE RENZ DMD (OWNER)
(701) 258-3308
Entity
Organization
Contact information
Practice address
714 S 2ND ST, BISMARCK, ND 58504-5718
(701) 258-3308
(701) 751-0349
Mailing address
714 S 2ND ST, BISMARCK, ND 58504-5718
(701) 258-3308
(701) 751-0349
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
NULL
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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