| Cld - Coon Rapids Mn, Llc | |
|
3790 Coon Rapids Blvd Nw Coon Rapids MN 55433-2629 | |
| (763) 200-5280 | |
| Not Available |
| Full Name | Cld - Coon Rapids Mn, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3790 Coon Rapids Blvd Nw, Coon Rapids, Minnesota |
| Authorized Official Name and Position | David Park (CEO/OWNER) |
| Authorized Official Contact | 6514449644 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cld - Coon Rapids Mn, Llc 3790 Coon Rapids Blvd Nw Coon Rapids MN 55433-2629 Ph: () - | Cld - Coon Rapids Mn, Llc 3790 Coon Rapids Blvd Nw Coon Rapids MN 55433-2629 Ph: (763) 200-5280 |
| NPI Number | 1366136269 |
|---|---|
| Provider Enumeration Date | 06/05/2023 |
| Last Update Date | 06/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366136269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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