| St Croix Valley Dental Pllc | |
|
10035 City Walk Dr Ste A Lake Elmo Dental Lake Elmo MN 55042 | |
| (651) 714-5555 | |
| (651) 439-2211 |
| Full Name | St Croix Valley Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 10035 City Walk Dr, Lake Elmo, Minnesota |
| Authorized Official Name and Position | Douglas Steven Wolff (OWNER DENTIST) |
| Authorized Official Contact | 6514392600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Croix Valley Dental Pllc 11240 Stillwater Blvd N Lake Elmo Dental Lake Elmo MN 55042 Ph: (651) 777-0210 | St Croix Valley Dental Pllc 10035 City Walk Dr Ste A Lake Elmo Dental Lake Elmo MN 55042 Ph: (651) 714-5555 |
| NPI Number | 1295859676 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295859676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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