| Miso Dentistry, PC | |
|
6240 Quinwood Ln N # 100 Maple Grove MN 55369-6384 | |
| (763) 391-6486 | |
| (763) 710-7485 |
| Full Name | Miso Dentistry, PC |
|---|---|
| Speciality | Dentist |
| Location | 6240 Quinwood Ln N # 100, Maple Grove, Minnesota |
| Authorized Official Name and Position | Hyeok Je Lee (PRESIDENT) |
| Authorized Official Contact | 7633315816 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miso Dentistry, PC 6240 Quinwood Ln N Ste 100 Maple Grove MN 55369-6384 Ph: (763) 331-5816 | Miso Dentistry, PC 6240 Quinwood Ln N # 100 Maple Grove MN 55369-6384 Ph: (763) 391-6486 |
| NPI Number | 1629538988 |
|---|---|
| Provider Enumeration Date | 03/22/2019 |
| Last Update Date | 08/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629538988 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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