| Premier Dental | |
|
1514 White Bear Ave N B Saint Paul MN 55106-1624 | |
| (817) 733-5469 | |
| Not Available |
| Full Name | Premier Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1514 White Bear Ave N, Saint Paul, Minnesota |
| Authorized Official Name and Position | Tom Y Lee (CEO) |
| Authorized Official Contact | 8177335469 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Dental 1514 White Bear Ave N B Saint Paul MN 55106-1624 Ph: (817) 733-5469 | Premier Dental 1514 White Bear Ave N B Saint Paul MN 55106-1624 Ph: (817) 733-5469 |
| NPI Number | 1427398411 |
|---|---|
| Provider Enumeration Date | 02/27/2013 |
| Last Update Date | 02/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427398411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D12859 (Minnesota) | Primary |
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