# NORTHERN LIGHTS DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790297430
- **Authorized official:** DR. CHRISTOPHER JOHN SCHMALTZ DDS (MANAGING MEMBER)
- **Authorized official phone:** (701) 799-4898

## Contact information

- **Practice address:** 4150 19TH AVE S, SUITE 301, FARGO, ND 58104
- **Practice address phone:** (701) 551-2000
- **Mailing address:** 325 LIBERTY LN, HORACE, ND 58047-4522
- **Mailing address phone:** (701) 799-4898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2162 | ND | Yes |

## Other

- **Enumeration date:** 11/03/2017
- **Last updated:** 11/03/2017