| Edp Of Minnesota Pc | |
|
5820 74th Ave N Ste 110 Brooklyn Park MN 55443-3140 | |
| (736) 561-7000 | |
| Not Available |
| Full Name | Edp Of Minnesota Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5820 74th Ave N Ste 110, Brooklyn Park, Minnesota |
| Authorized Official Name and Position | Roseanne Brunenkant (DIRECTOR OF INTEGRATIONS) |
| Authorized Official Contact | 3129373619 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edp Of Minnesota Pc 141 W Jackson Blvd Ste 210 Chicago IL 60604-3048 Ph: (312) 937-3619 | Edp Of Minnesota Pc 5820 74th Ave N Ste 110 Brooklyn Park MN 55443-3140 Ph: (736) 561-7000 |
| NPI Number | 1336642495 |
|---|---|
| Provider Enumeration Date | 03/15/2018 |
| Last Update Date | 09/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336642495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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