| Wyoming Family Dental, Pa | |
| 
					5305 E Viking Blvd Wyoming MN 55092-8014  | |
| (651) 462-5150 | |
| Not Available | 
| Full Name | Wyoming Family Dental, Pa | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 5305 E Viking Blvd, Wyoming, Minnesota | 
| Authorized Official Name and Position | Chad Loween (CO-OWNER) | 
| Authorized Official Contact | 6514625150 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Wyoming Family Dental, Pa 4666 Dale St N Shoreview MN 55126-6021 Ph: (651) 766-5771  | Wyoming Family Dental, Pa 5305 E Viking Blvd Wyoming MN 55092-8014 Ph: (651) 462-5150  | 
| NPI Number | 1720292402 | 
|---|---|
| Provider Enumeration Date | 05/10/2007 | 
| Last Update Date | 06/23/2008 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1720292402 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D11362 (Minnesota) | Primary | 
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