| Southill Dental Group Pa | |
|
2850 Curve Crest Blvd W Suite 200 Stillwater MN 55082-4039 | |
| (651) 439-9400 | |
| (651) 439-9402 |
| Full Name | Southill Dental Group Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2850 Curve Crest Blvd W, Stillwater, Minnesota |
| Authorized Official Name and Position | Donna Kobs (OFFICE MANAGER) |
| Authorized Official Contact | 6514399400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southill Dental Group Pa 2850 Curve Crest Blvd W Suite 200 Stillwater MN 55082-4039 Ph: (651) 439-9400 | Southill Dental Group Pa 2850 Curve Crest Blvd W Suite 200 Stillwater MN 55082-4039 Ph: (651) 439-9400 |
| NPI Number | 1770702714 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 04/02/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770702714 | NPI | - | NPPES |
| 1831419209 | Other | NPI GOSSAI | |
| 18386 | Other | MN | H. PARTNER ID - FLODIN |
| 1477692903 | Other | NPI KNUTSON | |
| 1184616005 | Other | MN | NPI - FLODIN |
| 9909 | Medicaid | MN | |
| 293218100 | Medicaid | MN | |
| 1477692903 | Medicaid | MN | |
| 1831419209 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12778 (Minnesota) | Primary |
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