| Dental Specialist Of Minnesota, Pllc | |
|
1835 County Road C W Ste 290 Roseville MN 55113-1343 | |
| (651) 501-0018 | |
| Not Available |
| Full Name | Dental Specialist Of Minnesota, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1835 County Road C W Ste 290, Roseville, Minnesota |
| Authorized Official Name and Position | Shannon Hesse (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 6517462815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Specialist Of Minnesota, Pllc 2200 County Road C W Ste 2210 Roseville MN 55113-2551 Ph: (651) 746-2815 | Dental Specialist Of Minnesota, Pllc 1835 County Road C W Ste 290 Roseville MN 55113-1343 Ph: (651) 501-0018 |
| NPI Number | 1992307839 |
|---|---|
| Provider Enumeration Date | 11/16/2020 |
| Last Update Date | 11/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992307839 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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