| Borealis Dental Studio, P.a. | |
|
12745 N 1st Ave Lindstrom MN 55045-9585 | |
| (651) 257-2720 | |
| Not Available |
| Full Name | Borealis Dental Studio, P.a. |
|---|---|
| Speciality | Dentist |
| Location | 12745 N 1st Ave, Lindstrom, Minnesota |
| Authorized Official Name and Position | Becky Goolsby (BUSINESS MANAGER) |
| Authorized Official Contact | 4058373159 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Borealis Dental Studio, P.a. 6892 256th St Wyoming MN 55092-8362 Ph: (405) 837-3159 | Borealis Dental Studio, P.a. 12745 N 1st Ave Lindstrom MN 55045-9585 Ph: (651) 257-2720 |
| NPI Number | 1922450634 |
|---|---|
| Provider Enumeration Date | 07/06/2016 |
| Last Update Date | 07/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922450634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D13152 (Minnesota) | Primary |
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