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General NPI Number Information
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NPI Number | 1376756163
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Entity Type | Organization
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Legal Business Name | SMILE SOLUTIONS, PC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 1324 23RD ST S SUITE 2A
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City | FARGO
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State | ND
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Zip | 58103-3702
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Country | US
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Telephone | 701-365-0507
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Fax | 701-365-0009
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Provider Business Mailing Address
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Address Line | 1910 42ND ST S SUITE A
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City | FARGO
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State | ND
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Zip | 58103-4416
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Country | US
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Telephone | 701-365-0507
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Fax | 701-365-0009
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEREMY P WEHRMAN
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Credential | DDS
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Telephone | 701-365-0507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 1959
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License Number State | ND
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