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Organization
BLAINE ORTHODONTICS
Active
Organization
BLAINE ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA SMITH (ORTHODONTIST)
(763) 400-8992
Entity
Organization
Contact information
Practice address
10945 CLUB WEST PKWY, BLAINE, MN 55449-6253
(763) 400-8992
Mailing address
10945 CLUB WEST PKWY, BLAINE, MN 55449-6253
(763) 400-8992
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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