| Aesthetic Dental Center | |
|
1207 W Divide Ave Bismarck ND 58501-1290 | |
| (701) 400-7283 | |
| Not Available |
| Full Name | Aesthetic Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 1207 W Divide Ave, Bismarck, North Dakota |
| Authorized Official Name and Position | Krysta Sellers (PROSTHODONTIST) |
| Authorized Official Contact | 7014007283 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aesthetic Dental Center 1207 W Divide Ave Bismarck ND 58501-1290 Ph: () - | Aesthetic Dental Center 1207 W Divide Ave Bismarck ND 58501-1290 Ph: (701) 400-7283 |
| NPI Number | 1639528334 |
|---|---|
| Provider Enumeration Date | 06/03/2016 |
| Last Update Date | 06/03/2016 |
| Medicare PECOS PAC ID | 3779873344 |
|---|---|
| Medicare Enrollment ID | O20160609002350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639528334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | 2181 (North Dakota) | Primary |
| Provider Name | Krysta L Sellers |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1508286998 PECOS PAC ID: 1254630569 Enrollment ID: I20160609002483 |
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