| NPI | 1285450544 |
|---|---|
| Other Name | MYSTICS SMILES |
| Entity Type | Organization |
| Authorized Contact | HEIDI KAINOA Dental Clinic Manager 701-224-2644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2024-12-10 |