| Distinctive Dental | |
|
7631 145th St W Apple Valley MN 55124-5511 | |
| (952) 432-8696 | |
| Not Available |
| Full Name | Distinctive Dental |
|---|---|
| Speciality | Dentist |
| Location | 7631 145th St W, Apple Valley, Minnesota |
| Authorized Official Name and Position | Charles N Miller (PRESIDENT) |
| Authorized Official Contact | 6127183149 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Distinctive Dental 7631 145th St W Apple Valley MN 55124-5511 Ph: (952) 432-8696 | Distinctive Dental 7631 145th St W Apple Valley MN 55124-5511 Ph: (952) 432-8696 |
| NPI Number | 1104126168 |
|---|---|
| Provider Enumeration Date | 10/25/2010 |
| Last Update Date | 07/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104126168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D10738 (Minnesota) | Primary |
| 122300000X | Dentist | D7255 (Minnesota) | Secondary |
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