| Crystal Dental Care Inc | |
|
5640 W Broadway Ave Crystal MN 55428-3556 | |
| (176) 353-7365 | |
| Not Available |
| Full Name | Crystal Dental Care Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5640 W Broadway Ave, Crystal, Minnesota |
| Authorized Official Name and Position | Kimberlee Murphy (OWNER) |
| Authorized Official Contact | 7635373655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal Dental Care Inc 5640 W Broadway Ave Crystal MN 55428-3556 Ph: (176) 353-7365 | Crystal Dental Care Inc 5640 W Broadway Ave Crystal MN 55428-3556 Ph: (176) 353-7365 |
| NPI Number | 1316689201 |
|---|---|
| Provider Enumeration Date | 04/11/2022 |
| Last Update Date | 04/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316689201 | NPI | - | NPPES |
| 1285706317 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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