# KAIBAB PC

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

## Provider details

- **NPI number:** 1578313201
- **Authorized official:** BRIELLE RENZ DMD (OWNER)
- **Authorized official phone:** (701) 258-3308

## Contact information

- **Practice address:** 714 S 2ND ST, BISMARCK, ND 58504-5718
- **Practice address phone:** (701) 258-3308
- **Practice address fax:** (701) 751-0349
- **Mailing address:** 714 S 2ND ST, BISMARCK, ND 58504-5718
- **Mailing address phone:** (701) 258-3308
- **Mailing address fax:** (701) 751-0349

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 03/25/2024
- **Last updated:** 03/25/2024