| Orchard Dental Group, P.l.l.c. | |
|
12 Long Lake Rd # 12 Mahtomedi MN 55115-6814 | |
| (651) 770-2699 | |
| (651) 770-9896 |
| Full Name | Orchard Dental Group, P.l.l.c. |
|---|---|
| Speciality | Dentist |
| Location | 12 Long Lake Rd # 12, Mahtomedi, Minnesota |
| Authorized Official Name and Position | Robert J Marolt (PARTNER) |
| Authorized Official Contact | 6517702699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orchard Dental Group, P.l.l.c. 12 Long Lake Rd # 12 Mahtomedi MN 55115-6814 Ph: (651) 770-2699 | Orchard Dental Group, P.l.l.c. 12 Long Lake Rd # 12 Mahtomedi MN 55115-6814 Ph: (651) 770-2699 |
| NPI Number | 1932335098 |
|---|---|
| Provider Enumeration Date | 06/03/2009 |
| Last Update Date | 06/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932335098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D9611 (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 Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 814 Mahtomedi Ave, Mahtomedi, MN 55115 Phone: 651-426-0011 | |
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 |