| Chaska Pediatric Dentistry, P.a. | |
|
111 Hundertmark Rd Suite 304n Chaska MN 55318-4551 | |
| (952) 475-3135 | |
| Not Available |
| Full Name | Chaska Pediatric Dentistry, P.a. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 111 Hundertmark Rd, Chaska, Minnesota |
| Authorized Official Name and Position | Taylor Stephens (OWNER/PRESIDENT) |
| Authorized Official Contact | 9524753135 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chaska Pediatric Dentistry, P.a. 250 Central Ave N Suite 113 Wayzata MN 55391-1206 Ph: (952) 475-3135 | Chaska Pediatric Dentistry, P.a. 111 Hundertmark Rd Suite 304n Chaska MN 55318-4551 Ph: (952) 475-3135 |
| NPI Number | 1063834588 |
|---|---|
| Provider Enumeration Date | 01/17/2014 |
| Last Update Date | 01/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063834588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D12818 (Minnesota) | Primary |
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