Organization
SMILE DESIGN DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COREY JENSEN D.D.S. (OWNER)
(763) 537-1238
Entity
Organization
Contact information
Practice address
3475 PLYMOUTH BLVD, 100, PLYMOUTH, MN 55447-1499
(763) 537-1238
(763) 537-4627
Mailing address
3475 PLYMOUTH BLVD, 100, PLYMOUTH, MN 55447-1499
(763) 537-1238
(763) 537-4627
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/01/2011
Last updated
02/01/2011
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