| Bluff Creek Dental | |
|
600 Market St Ste 130 Chanhassen MN 55317-4570 | |
| (952) 937-5200 | |
| Not Available |
| Full Name | Bluff Creek Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 600 Market St Ste 130, Chanhassen, Minnesota |
| Authorized Official Name and Position | Christopher Ibberson (DDS/OWNER) |
| Authorized Official Contact | 5072275549 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluff Creek Dental 600 Market St Ste 130 Chanhassen MN 55317-4570 Ph: (952) 937-5200 | Bluff Creek Dental 600 Market St Ste 130 Chanhassen MN 55317-4570 Ph: (952) 937-5200 |
| NPI Number | 1770190951 |
|---|---|
| Provider Enumeration Date | 09/30/2020 |
| Last Update Date | 10/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770190951 | NPI | - | NPPES |
| 1720165905 | Medicaid | MN | |
| 1225140593 | Other | MN | CMS |
| 1447691431 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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