| Bay Creek Dental | |
|
1495 County Road 101 N Suite 2 Plymouth MN 55447-3078 | |
| (763) 476-6774 | |
| Not Available |
| Full Name | Bay Creek Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1495 County Road 101 N, Plymouth, Minnesota |
| Authorized Official Name and Position | Paul D Boettner (OWNER) |
| Authorized Official Contact | 7634766774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Creek Dental 1495 County Road 101 N Suite 2 Plymouth MN 55447 Ph: (763) 476-6774 | Bay Creek Dental 1495 County Road 101 N Suite 2 Plymouth MN 55447-3078 Ph: (763) 476-6774 |
| NPI Number | 1679765929 |
|---|---|
| Provider Enumeration Date | 08/10/2007 |
| Last Update Date | 06/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679765929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D12160 (Minnesota) | Primary |
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