Provider Demographics
NPI:1326479288
Name:TWIN SMILES
Entity Type:Organization
Organization Name:TWIN SMILES
Other - Org Name:ALPINE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZKALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-536-1118
Mailing Address - Street 1:5237 DOUGLAS DR N
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55429-3103
Mailing Address - Country:US
Mailing Address - Phone:763-536-1118
Mailing Address - Fax:763-536-2244
Practice Address - Street 1:5237 DOUGLAS DR N
Practice Address - Street 2:
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55429-3103
Practice Address - Country:US
Practice Address - Phone:763-536-1118
Practice Address - Fax:763-536-2244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty