Organization
HEALTHY SMILES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON MARIE KRUCKEBERG RDH (EXECUTIVE DIRECTOR)
(507) 319-6845
Entity
Organization
Contact information
Practice address
63407 130TH AVE, CLAREMONT, MN 55924-4656
(507) 319-6845
Mailing address
63407 130TH AVE, CLAREMONT, MN 55924-4656
(507) 319-6845
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
11/24/2009
Last updated
11/24/2009
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