Organization
SMILE LABS SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER EISENHUTH DDS (PRESIDENT)
(651) 406-8100
Entity
Organization
Contact information
Practice address
867 GRAND AVENUE, ST. PAUL, MN 55105
(651) 222-5133
Mailing address
3340 SHERMAN COURT, EAGAN, MN 55121
(651) 406-8100
(651) 406-8060
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
MN10874
MN
Other
Enumeration date
12/28/2017
Last updated
12/28/2017
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