| James G Koller Dds,pa | |
|
2601 Centennial Dr Ste 102 North St Paul MN 55109-3087 | |
| (651) 777-6454 | |
| (651) 773-9206 |
| Full Name | James G Koller Dds,pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2601 Centennial Dr Ste 102, North St Paul, Minnesota |
| Authorized Official Name and Position | James G Koller (DENTIST) |
| Authorized Official Contact | 6517776454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James G Koller Dds,pa 2601 Centennial Dr Ste 102 North St Paul MN 55109-3087 Ph: (651) 777-6454 | James G Koller Dds,pa 2601 Centennial Dr Ste 102 North St Paul MN 55109-3087 Ph: (651) 777-6454 |
| NPI Number | 1174989743 |
|---|---|
| Provider Enumeration Date | 01/12/2016 |
| Last Update Date | 12/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174989743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 10366 (Minnesota) | Primary |
North St. Paul Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2082 11th Ave E, North St Paul, MN 55109 Phone: 651-770-6260 |