| Maple Grove Periodontics and Implant Dentistry | |
|
12000 Elm Creek Blvd N Ste 320 Maple Grove MN 55369-7076 | |
| (763) 420-0200 | |
| Not Available |
| Full Name | Maple Grove Periodontics and Implant Dentistry |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 12000 Elm Creek Blvd N Ste 320, Maple Grove, Minnesota |
| Authorized Official Name and Position | Yun Wang (PRESIDENT) |
| Authorized Official Contact | 5176483576 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maple Grove Periodontics and Implant Dentistry 18145 59th Ave N Plymouth MN 55446-3936 Ph: (517) 648-3576 | Maple Grove Periodontics and Implant Dentistry 12000 Elm Creek Blvd N Ste 320 Maple Grove MN 55369-7076 Ph: (763) 420-0200 |
| NPI Number | 1093442048 |
|---|---|
| Provider Enumeration Date | 08/01/2022 |
| Last Update Date | 09/07/2022 |
| Certification Date | 09/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093442048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (NU) | Primary |
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