| Borealis Dental Wyoming Pa | |
|
26357 Forest Blvd # 2 Wyoming MN 55092-8353 | |
| (651) 462-7017 | |
| Not Available |
| Full Name | Borealis Dental Wyoming Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 26357 Forest Blvd # 2, Wyoming, Minnesota |
| Authorized Official Name and Position | Sean Goolsby (PRESIDENT) |
| Authorized Official Contact | 6517570482 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Borealis Dental Wyoming Pa Po Box 886 Wyoming MN 55092-0886 Ph: () - | Borealis Dental Wyoming Pa 26357 Forest Blvd # 2 Wyoming MN 55092-8353 Ph: (651) 462-7017 |
| NPI Number | 1750147492 |
|---|---|
| Provider Enumeration Date | 02/21/2024 |
| Last Update Date | 11/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750147492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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Sunrise River Dental Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 26357 Forest Blvd, Wyoming, MN 55092 Phone: 651-462-7017 |