| Chicago Dentists | |
|
2120 Nicollet Ave Minneapolis MN 55404-2528 | |
| (612) 870-4646 | |
| (612) 870-7870 |
| Full Name | Chicago Dentists |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2120 Nicollet Ave, Minneapolis, Minnesota |
| Authorized Official Name and Position | Noel Korengold (BUSINESS MANAGER) |
| Authorized Official Contact | 6128704646 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Dentists 2120 Nicollet Ave Minneapolis MN 55404-2528 Ph: (612) 870-4646 | Chicago Dentists 2120 Nicollet Ave Minneapolis MN 55404-2528 Ph: (612) 870-4646 |
| NPI Number | 1922184621 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 07/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922184621 | NPI | - | NPPES |
| 408522100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 9164 (Minnesota) | Primary |
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