Borealis Dental Wyoming Pa | |
26357 Forest Blvd # 2 Wyoming MN 55092-8353 | |
(651) 462-7017 | |
Not Available |
Full Name | Borealis Dental Wyoming Pa |
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Speciality | Dentist - General Practice |
Location | 26357 Forest Blvd # 2, Wyoming, Minnesota |
Authorized Official Name and Position | Sean Goolsby (PRESIDENT) |
Authorized Official Contact | 6517570482 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Borealis Dental Wyoming Pa Po Box 886 Wyoming MN 55092-0886 Ph: () - | Borealis Dental Wyoming Pa 26357 Forest Blvd # 2 Wyoming MN 55092-8353 Ph: (651) 462-7017 |
NPI Number | 1750147492 |
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Provider Enumeration Date | 02/21/2024 |
Last Update Date | 11/05/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750147492 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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