| Patrick J Ennen DDS PA | |
|
3960 Coon Rapids Blvd Nw 213 Coon Rapids MN 55433-2569 | |
| (763) 427-4912 | |
| Not Available |
| Full Name | Patrick J Ennen DDS PA |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3960 Coon Rapids Blvd Nw, Coon Rapids, Minnesota |
| Authorized Official Name and Position | Patrick Joseph Ennen (PRESIDENT) |
| Authorized Official Contact | 7634274912 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Patrick J Ennen DDS PA 3960 Coon Rapids Blvd Nw 213 Coon Rapids MN 55433-2569 Ph: (763) 427-4912 | Patrick J Ennen DDS PA 3960 Coon Rapids Blvd Nw 213 Coon Rapids MN 55433-2569 Ph: (763) 427-4912 |
| NPI Number | 1346393485 |
|---|---|
| Provider Enumeration Date | 01/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346393485 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 7668 (Minnesota) | Primary |
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