| Abc Dental Pa | |
|
3371 Coon Rapids Blvd Nw Coon Rapids MN 55433-2624 | |
| (763) 421-4640 | |
| (763) 421-0112 |
| Full Name | Abc Dental Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3371 Coon Rapids Blvd Nw, Coon Rapids, Minnesota |
| Authorized Official Name and Position | Katherine M C Bolterman (OWNER PRESIDENT) |
| Authorized Official Contact | 7634214640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Abc Dental Pa 3371 Coon Rapids Blvd Nw Coon Rapids MN 55433-2624 Ph: (763) 421-4640 | Abc Dental Pa 3371 Coon Rapids Blvd Nw Coon Rapids MN 55433-2624 Ph: (763) 421-4640 |
| NPI Number | 1972650745 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972650745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D11438 (Minnesota) | Primary |
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