| Camp Smile | |
|
2855 Campus Drive, Suite 360 Plymouth MN 55441 | |
| (763) 383-1788 | |
| (763) 383-1768 |
| Full Name | Camp Smile |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2855 Campus Drive, Suite 360, Plymouth, Minnesota |
| Authorized Official Name and Position | Daniel G Raether (PRESIDENT) |
| Authorized Official Contact | 7633831788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Camp Smile 2855 Campus Drive, Suite 360 Plymouth MN 55441 Ph: (763) 383-1788 | Camp Smile 2855 Campus Drive, Suite 360 Plymouth MN 55441 Ph: (763) 383-1788 |
| NPI Number | 1780722942 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 08/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780722942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 10086 (Minnesota) | Primary |
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