| Wooddale Dental Group Pa | |
|
3401 Wooddale Ave S St Louis Park MN 55416-2340 | |
| (952) 929-3336 | |
| (952) 929-3338 |
| Full Name | Wooddale Dental Group Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3401 Wooddale Ave S, St Louis Park, Minnesota |
| Authorized Official Name and Position | Michael James Spencer (PRESIDENT) |
| Authorized Official Contact | 9529293336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wooddale Dental Group Pa 3401 Wooddale Ave S St Louis Park MN 55416-2340 Ph: (952) 929-3336 | Wooddale Dental Group Pa 3401 Wooddale Ave S St Louis Park MN 55416-2340 Ph: (952) 929-3336 |
| NPI Number | 1356404883 |
|---|---|
| Provider Enumeration Date | 12/18/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356404883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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