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Organization

CENTER FOR SMILE DESIGN, LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES O'CONNELL DDS (PRESIDENT)
(701) 746-1481
Entity
Organization

Contact information

Practice address
117 N WASHINGTON ST, GRAND FORKS, ND 58203-3450
(701) 746-1481
(701) 746-6201
Mailing address
117 N WASHINGTON ST, GRAND FORKS, ND 58203-3450
(701) 746-1481
(701) 746-6201

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1635
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000719850
UNITED CONCORDIA
01
1635
BLUE CROSS BLUE SHIELD OF ND
ND
01
1635
DELTA DENTAL
05
41259
ND
Enumeration date
07/23/2015
Last updated
07/23/2015
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