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Organization

ABOUT SMILES DENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SVETLANA KONSTANTINOVNA SAMPSON DDS (OWNER)
(214) 790-5151
Entity
Organization

Contact information

Practice address
4575 23RD AVE S STE 1200, FARGO, ND 58104-8784
(701) 356-4077
(701) 356-2108
Mailing address
4575 23RD AVE S STE 1200, FARGO, ND 58104-8784
(701) 356-4077
(701) 356-2108

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2105
ND

Other

Enumeration date
05/27/2013
Last updated
05/28/2013
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