Organization
SMILES AROUND MINNESOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELDON LAS (REGISTERED DENTAL HYGIENIST)
(507) 923-7235
Entity
Organization
Contact information
Practice address
842 BALSAM CT NE, PINE ISLAND, MN 55963-7634
(507) 923-7235
Mailing address
842 BALSAM CT NE, PINE ISLAND, MN 55963-7634
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6244
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548517469
—
MN
Enumeration date
08/14/2016
Last updated
08/14/2016
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