| 36th Street Dental | |
|
5806a W 36th St St Louis Park MN 55416-5108 | |
| (952) 929-5292 | |
| Not Available |
| Full Name | 36th Street Dental |
|---|---|
| Speciality | Dentist |
| Location | 5806a W 36th St, St Louis Park, Minnesota |
| Authorized Official Name and Position | Ryan Michael Dunlavey (PRESIDENT) |
| Authorized Official Contact | 6127997525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 36th Street Dental 5806a W 36th St St Louis Park MN 55416-5108 Ph: (952) 929-5292 | 36th Street Dental 5806a W 36th St St Louis Park MN 55416-5108 Ph: (952) 929-5292 |
| NPI Number | 1417340563 |
|---|---|
| Provider Enumeration Date | 03/13/2015 |
| Last Update Date | 03/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417340563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Minnesota) | Primary |
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