Provider Demographics
NPI:1649673096
Name:ALL ABOUT SMILES, PIPESTONE LLC
Entity type:Organization
Organization Name:ALL ABOUT SMILES, PIPESTONE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:HEEZEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:888-825-4214
Mailing Address - Street 1:118 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PIPESTONE
Mailing Address - State:MN
Mailing Address - Zip Code:56164-1652
Mailing Address - Country:US
Mailing Address - Phone:888-825-4214
Mailing Address - Fax:507-825-4216
Practice Address - Street 1:118 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PIPESTONE
Practice Address - State:MN
Practice Address - Zip Code:56164-1652
Practice Address - Country:US
Practice Address - Phone:888-825-4214
Practice Address - Fax:507-825-4216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND131031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty