Organization
BISMARCK STATE COLLEGE
Active
Other names
Mystics Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI KAINOA RDH (DENTAL CLINIC MANAGER)
(701) 224-2644
Entity
Organization
Contact information
Practice address
210 W CENTURY AVE, BISMARCK, ND 58503-1494
(701) 224-2644
Mailing address
210 W CENTURY AVE, BISMARCK, ND 58503-1494
(701) 224-2644
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/02/2024
Last updated
12/10/2024
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