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683 Bielenberg Dr Suite 205 Woodbury MN 55125-1705 | |
| (651) 200-4747 | |
| (651) 998-1009 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 683 Bielenberg Dr, Woodbury, Minnesota |
| Authorized Official Name and Position | Marjan Javanmardian (DENTIST/OWNER) |
| Authorized Official Contact | 6512004747 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
683 Bielenberg Dr Suite 205 Woodbury MN 55125-1705 Ph: (651) 200-4747 | 683 Bielenberg Dr Suite 205 Woodbury MN 55125-1705 Ph: (651) 200-4747 |
| NPI Number | 1245250596 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 02/07/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245250596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | L11291 (Minnesota) | Primary |
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