Healthcare Provider Details

I. General information

NPI: 1881933034
Provider Name (Legal Business Name): SINCERE SMILES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2224 1ST AVE W STE 1
WILLISTON ND
58801-6286
US

IV. Provider business mailing address

2224 1ST AVE W
WILLISTON ND
58801-6286
US

V. Phone/Fax

Practice location:
  • Phone: 701-577-7611
  • Fax: 701-577-0139
Mailing address:
  • Phone: 701-577-7611
  • Fax: 701-577-0139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: KAMILA DORNFELD
Title or Position: OWNER
Credential: D.D.S.
Phone: 701-577-7611