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General NPI Number Information
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NPI Number | 1457541740
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Entity Type | Organization
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Legal Business Name | BERNHARDT & SMITH ORTHODONTICS, PC
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 9295 BISHOP DRIVE SUITE 120
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City | WEST DES MOINES
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State | IA
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Zip | 50266
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Country | US
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Telephone | 515-987-9130
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Fax | 515-987-9133
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Provider Business Mailing Address
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Address Line | 9295 BISHOP DRIVE SUITE 120
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City | WEST DES MOINES
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State | IA
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Zip | 50266
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Country | US
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Telephone | 515-987-9130
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Fax | 515-987-9133
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MELISSA K BERNHARDT
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Credential | DDS
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Telephone | 515-987-9130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 07821
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License Number State | IA
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