| Blaine Kidds Pediatric Dentistry Pllc | |
|
1351 113th Ave Ne Blaine MN 55434-3874 | |
| (651) 324-4270 | |
| Not Available |
| Full Name | Blaine Kidds Pediatric Dentistry Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1351 113th Ave Ne, Blaine, Minnesota |
| Authorized Official Name and Position | Darcy J Rindelaub (OWNER) |
| Authorized Official Contact | 6513244270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blaine Kidds Pediatric Dentistry Pllc 400 2nd St S Ste 250 Hudson WI 54016-1599 Ph: (715) 808-0460 | Blaine Kidds Pediatric Dentistry Pllc 1351 113th Ave Ne Blaine MN 55434-3874 Ph: (651) 324-4270 |
| NPI Number | 1538678057 |
|---|---|
| Provider Enumeration Date | 09/27/2017 |
| Last Update Date | 09/27/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538678057 | NPI | - | NPPES |
| 122648700 | Medicaid | MN | |
| 1639126683 | Other | PROVIDER NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D11365 (Minnesota) | Primary |
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