| Dentalign P.a. | |
|
7860 Main St Maple Grove MN 55369 | |
| (763) 420-1030 | |
| Not Available |
| Full Name | Dentalign P.a. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 7860 Main St, Maple Grove, Minnesota |
| Authorized Official Name and Position | Chad Holly Kelly (PRESIDENT) |
| Authorized Official Contact | 6127010478 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentalign P.a. 4630 Edgebrook Pl Edina MN 55424 Ph: (612) 701-0478 | Dentalign P.a. 7860 Main St Maple Grove MN 55369 Ph: (763) 420-1030 |
| NPI Number | 1003174764 |
|---|---|
| Provider Enumeration Date | 05/01/2012 |
| Last Update Date | 05/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003174764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D11493 (Minnesota) | Primary |
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