NPI 1023463320

Legendary Smiles, P.C.

Organisation Dental Clinic/Center Watford City, ND

Practice location

Address: 109 5th St SW, Watford City, ND 58854-7135
Phone: (701) 842-4474
Fax: (701) 842-4472
Mailing address: 109 5th St SW PO Box 486, Watford City, ND 58854-7135

Authorised official

Name: Monty Stewart Bulzomi
Title: Owner/Dentist
Phone: (701) 842-4474

Registered specialties

Dental Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QD0000X Licence 2238 (ND)

Other Clinic/Center providers in North Dakota →

Registry record

NPI: 1023463320
Entity type: Organization
NPI issued: 25 Apr 2016
Record last updated: 25 Apr 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.