| Dakota Children's Dentistry | |
|
3410 151st St W Rosemount MN 55068-1755 | |
| (651) 322-5788 | |
| (651) 322-4257 |
| Full Name | Dakota Children's Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3410 151st St W, Rosemount, Minnesota |
| Authorized Official Name and Position | Daniel H Glenn (PRESIDENT) |
| Authorized Official Contact | 6513225788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dakota Children's Dentistry 3410 151st St W Rosemount MN 55068-1755 Ph: (651) 322-5788 | Dakota Children's Dentistry 3410 151st St W Rosemount MN 55068-1755 Ph: (651) 322-5788 |
| NPI Number | 1306924584 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306924584 | NPI | - | NPPES |
| 3049280 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D10462 (Minnesota) | Primary |
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