| 123 Brush Dental Llc | |
|
1670 Beam Ave Ste 202 Maplewood MN 55109 | |
| (651) 779-4195 | |
| Not Available |
| Full Name | 123 Brush Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1670 Beam Ave, Maplewood, Minnesota |
| Authorized Official Name and Position | Vacharee Sriswad Peterson (DENTIST) |
| Authorized Official Contact | 6517794195 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 123 Brush Dental Llc 1670 Beam Ave Ste 202 Maplewood MN 55109 Ph: (651) 779-4195 | 123 Brush Dental Llc 1670 Beam Ave Ste 202 Maplewood MN 55109 Ph: (651) 779-4195 |
| NPI Number | 1053807016 |
|---|---|
| Provider Enumeration Date | 07/02/2018 |
| Last Update Date | 07/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053807016 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D9309 (Minnesota) | Primary |
Estee Wang, Dmd Ms, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1668 Cope Ave E, Maplewood, MN 55109 Phone: 651-777-7300 | |
Healthpartners Maplewood Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2165 White Bear Ave N, Maplewood, MN 55109 Phone: 651-770-8828 Fax: 651-779-1570 | |
Nerness Endodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2480 White Bear Ave N Ste 202, Maplewood, MN 55109 Phone: 651-777-7744 | |
Hoglund Wallin Dentistry Partnership Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1270 Cope Ave E, Maplewood, MN 55109 Phone: 651-482-8332 Fax: 651-482-7839 | |
Peter H Mielke Dds Pediatric Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1675 Beam Ave Ste 202, Maplewood, MN 55109 Phone: 651-779-9002 | |
Dr. Roger C. Stoddard Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2480 White Bear Ave N Ste 202, Maplewood, MN 55109 Phone: 651-776-1597 |