| Shine Dental LLC | |
|
1020 4th St Se Ste 200 Saint Cloud MN 56304-1245 | |
| (320) 980-6031 | |
| Not Available |
| Full Name | Shine Dental LLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1020 4th St Se Ste 200, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Mahado Onwukwe (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3209806031 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shine Dental LLC 1020 4th St Se Ste 200 Saint Cloud MN 56304-1245 Ph: (320) 980-6031 | Shine Dental LLC 1020 4th St Se Ste 200 Saint Cloud MN 56304-1245 Ph: (320) 980-6031 |
| NPI Number | 1114832839 |
|---|---|
| Provider Enumeration Date | 08/17/2026 |
| Last Update Date | 08/17/2026 |
| Certification Date | 08/17/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114832839 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
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