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Organization
FOREVER SMILES PARTNERS PLLC
Active
Organization
FOREVER SMILES PARTNERS PLLC
Active
Other names
Bluff Creek Dental
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER IBBERSON (DDS/OWNER)
(507) 227-5549
Entity
Organization
Contact information
Practice address
600 MARKET ST STE 130, CHANHASSEN, MN 55317-4570
(952) 937-5200
Mailing address
600 MARKET ST STE 130, CHANHASSEN, MN 55317-4570
(952) 937-5200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225140593
CMS
MN
05
—
1447691431
—
MN
05
—
1720165905
—
MN
Enumeration date
09/30/2020
Last updated
10/18/2023
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