| Carousel Pediatric Dentistry Pllc | |
|
15160 Foliage Ave Ste 110 Apple Valley MN 55124-5916 | |
| (952) 715-6177 | |
| Not Available |
| Full Name | Carousel Pediatric Dentistry Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 15160 Foliage Ave Ste 110, Apple Valley, Minnesota |
| Authorized Official Name and Position | Kyle Nordeen (OWNER) |
| Authorized Official Contact | 9527156177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carousel Pediatric Dentistry Pllc 15160 Foliage Ave Ste 110 Apple Valley MN 55124-5916 Ph: (952) 715-6177 | Carousel Pediatric Dentistry Pllc 15160 Foliage Ave Ste 110 Apple Valley MN 55124-5916 Ph: (952) 715-6177 |
| NPI Number | 1114514205 |
|---|---|
| Provider Enumeration Date | 12/23/2020 |
| Last Update Date | 12/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114514205 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
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