Organization
SMILES ON SEVENTH, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANN ELIZABETH JENNEN D.D.S. (DENTIST)
(651) 699-1234
Entity
Organization
Contact information
Practice address
2390 7TH ST W, SAINT PAUL, MN 55116-2800
(651) 699-1234
(651) 699-7715
Mailing address
2390 7TH ST W, SAINT PAUL, MN 55116-2800
(651) 699-1234
(651) 699-7715
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D11243
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0316022000
MEDICARE
MN
05
—
0316022000
—
MN
Enumeration date
07/17/2009
Last updated
07/17/2009
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