Organization
WEST CENTRAL SMILES PA
Active
Organization
WEST CENTRAL SMILES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY JOHNSON (DR./CEO)
(320) 235-3102
Entity
Organization
Contact information
Practice address
206 ATLANTIC AVE, MORRIS, MN 56267-1321
(320) 235-3102
Mailing address
1100 19TH AVE SW, SUITE 1, WILLMAR, MN 56201-5288
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
10/29/2008
Last updated
11/09/2013
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