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3909 Silver Lake Rd Ne Minneapolis MN 55421-4352 | |
| (612) 789-3573 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3909 Silver Lake Rd Ne, Minneapolis, Minnesota |
| Authorized Official Name and Position | Rebecca M Kipp (OFFICE MANAGER) |
| Authorized Official Contact | 6127893573 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3909 Silver Lake Rd Ne Minneapolis MN 55421-4352 Ph: (612) 789-3573 | 3909 Silver Lake Rd Ne Minneapolis MN 55421-4352 Ph: (612) 789-3573 |
| NPI Number | 1184046385 |
|---|---|
| Provider Enumeration Date | 01/08/2014 |
| Last Update Date | 01/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184046385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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