| Mahtomedi Family Dental | |
| 
					814 Mahtomedi Ave Mahtomedi MN 55115-1730  | |
| (651) 426-0011 | |
| Not Available | 
| Full Name | Mahtomedi Family Dental | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 814 Mahtomedi Ave, Mahtomedi, Minnesota | 
| Authorized Official Name and Position | Brian Welle (DOCTOR) | 
| Authorized Official Contact | 6514260011 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mahtomedi Family Dental 814 Mahtomedi Ave Mahtomedi MN 55115-1730 Ph: () -  | Mahtomedi Family Dental 814 Mahtomedi Ave Mahtomedi MN 55115-1730 Ph: (651) 426-0011  | 
| NPI Number | 1720415896 | 
|---|---|
| Provider Enumeration Date | 10/03/2013 | 
| Last Update Date | 10/03/2013 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1720415896 | NPI | - | NPPES | 
| 1811212624 | Medicaid | MN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D7721 (Minnesota) | Primary | 
Mahtomedi Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 814 Mahtomedi Ave, Mahtomedi, MN 55115 Phone: 651-426-0011 Fax: 651-426-2075  | |
Mahtomedi Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 814 Mahtomedi Ave, Mahtomedi Dental, Mahtomedi, MN 55115 Phone: 651-426-0011 Fax: 651-426-2075  | |
Orchard Dental Group, P.l.l.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12 Long Lake Rd # 12, Mahtomedi, MN 55115 Phone: 651-770-2699 Fax: 651-770-9896  |