| Family & Cosmetic Gentle Dentistry | |
|
4787 Shoreline Dr Spring Park MN 55384-9713 | |
| (952) 471-0900 | |
| (952) 471-1046 |
| Full Name | Family & Cosmetic Gentle Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4787 Shoreline Dr, Spring Park, Minnesota |
| Authorized Official Name and Position | Diana Gavic (OPERATIONS MANAGER) |
| Authorized Official Contact | 9522249771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family & Cosmetic Gentle Dentistry 6600 France Ave S Ste 415 Edina MN 55435-1817 Ph: (952) 224-9771 | Family & Cosmetic Gentle Dentistry 4787 Shoreline Dr Spring Park MN 55384-9713 Ph: (952) 471-0900 |
| NPI Number | 1790967248 |
|---|---|
| Provider Enumeration Date | 11/27/2007 |
| Last Update Date | 06/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790967248 | NPI | - | NPPES |
| 318092100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Kyle R Danielson, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4165 Shoreline Dr Ste 30, Spring Park, MN 55384 Phone: 952-471-0047 |