| Blue Ridge Dental Center Pa | |
|
11601 Minnetonka Mills Rd Suite D Minnetonka MN 55305-5161 | |
| (952) 938-8858 | |
| Not Available |
| Full Name | Blue Ridge Dental Center Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11601 Minnetonka Mills Rd, Minnetonka, Minnesota |
| Authorized Official Name and Position | Justin J Mchugh (VICE PRESIDENT) |
| Authorized Official Contact | 9529388858 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Dental Center Pa 11601 Minnetonka Mills Rd Suite D Minnetonka MN 55305-5161 Ph: (952) 938-8858 | Blue Ridge Dental Center Pa 11601 Minnetonka Mills Rd Suite D Minnetonka MN 55305-5161 Ph: (952) 938-8858 |
| NPI Number | 1952468654 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952468654 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D11518 (Minnesota) | Primary |
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