| St. Croix Endodontics | |
|
25 Lake St N Suite 110 Forest Lake MN 55025-2535 | |
| (651) 464-7388 | |
| (651) 982-6236 |
| Full Name | St. Croix Endodontics |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 25 Lake St N, Forest Lake, Minnesota |
| Authorized Official Name and Position | Serena Jean Pedersen (OFFICE MANAGER) |
| Authorized Official Contact | 7637679119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Croix Endodontics 25 Lake St N Suite 110 Forest Lake MN 55025-2535 Ph: (651) 464-7388 | St. Croix Endodontics 25 Lake St N Suite 110 Forest Lake MN 55025-2535 Ph: (651) 464-7388 |
| NPI Number | 1952709420 |
|---|---|
| Provider Enumeration Date | 12/15/2014 |
| Last Update Date | 11/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952709420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | (* (Not Available)) | Primary |
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