| White Bear Smiles, P.a. | |
|
4778 Banning Ave White Bear Lake MN 55110-3264 | |
| (651) 426-8998 | |
| Not Available |
| Full Name | White Bear Smiles, P.a. |
|---|---|
| Speciality | Dentist |
| Location | 4778 Banning Ave, White Bear Lake, Minnesota |
| Authorized Official Name and Position | Paul Daniel Anderson (PRESIDENT) |
| Authorized Official Contact | 6514268998 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| White Bear Smiles, P.a. 4778 Banning Ave White Bear Lake MN 55110-3264 Ph: (651) 426-8998 | White Bear Smiles, P.a. 4778 Banning Ave White Bear Lake MN 55110-3264 Ph: (651) 426-8998 |
| NPI Number | 1396202917 |
|---|---|
| Provider Enumeration Date | 03/01/2019 |
| Last Update Date | 03/01/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396202917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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