| Minnesota Dental Surgery Pllc | |
|
9801 Dupont Ave S Bloomington MN 55431-3100 | |
| (952) 215-7419 | |
| Not Available |
| Full Name | Minnesota Dental Surgery Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9801 Dupont Ave S, Bloomington, Minnesota |
| Authorized Official Name and Position | Bennett Isabella (CEO) |
| Authorized Official Contact | 9522157419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Dental Surgery Pllc 3510 120th St W Rosemount MN 55068-3501 Ph: (952) 215-7419 | Minnesota Dental Surgery Pllc 9801 Dupont Ave S Bloomington MN 55431-3100 Ph: (952) 215-7419 |
| NPI Number | 1124478607 |
|---|---|
| Provider Enumeration Date | 06/15/2016 |
| Last Update Date | 06/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124478607 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D12540 (Minnesota) | Primary |
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