Provider Demographics
NPI:1174184964
Name:NATURAL SMILES DENTAL CARE
Entity Type:Organization
Organization Name:NATURAL SMILES DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-483-9800
Mailing Address - Street 1:3434 LEXINGTON AVE. N
Mailing Address - Street 2:SUITE 700
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126
Mailing Address - Country:US
Mailing Address - Phone:651-483-9800
Mailing Address - Fax:651-483-5264
Practice Address - Street 1:3434 LEXINGTON AVE. N
Practice Address - Street 2:SUITE 700
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126
Practice Address - Country:US
Practice Address - Phone:651-483-9800
Practice Address - Fax:651-483-5264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental