| Advanced Dentistry Inc. | |
|
5020 Minnetonka Blvd St Louis Park MN 55416-2255 | |
| (952) 285-1677 | |
| Not Available |
| Full Name | Advanced Dentistry Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5020 Minnetonka Blvd, St Louis Park, Minnesota |
| Authorized Official Name and Position | Rita Lyansky (CEO) |
| Authorized Official Contact | 9522851677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dentistry Inc. 5020 Minnetonka Blvd St Louis Park MN 55416-2255 Ph: (952) 285-1677 | Advanced Dentistry Inc. 5020 Minnetonka Blvd St Louis Park MN 55416-2255 Ph: (952) 285-1677 |
| NPI Number | 1760693972 |
|---|---|
| Provider Enumeration Date | 05/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760693972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 11287 (Minnesota) | Primary |
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