| Dental Specialists Of Minnesota, Pllc | |
|
1109 Moore Lake Dr E Fridley MN 55432-5171 | |
| (763) 571-9990 | |
| (763) 572-2226 |
| Full Name | Dental Specialists Of Minnesota, Pllc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1109 Moore Lake Dr E, Fridley, Minnesota |
| Authorized Official Name and Position | Alan Law (PRESIDENT) |
| Authorized Official Contact | 6516330500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Specialists Of Minnesota, Pllc 2200 County Road C W Suite 2210 Roseville MN 55113-2550 Ph: (651) 633-0500 | Dental Specialists Of Minnesota, Pllc 1109 Moore Lake Dr E Fridley MN 55432-5171 Ph: (763) 571-9990 |
| NPI Number | 1003245333 |
|---|---|
| Provider Enumeration Date | 11/07/2013 |
| Last Update Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003245333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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