| Family & Cosmetic Gentle Dentistry, Ltd | |
|
97 85th Ave Nw Coon Rapids MN 55433-6022 | |
| (952) 224-9771 | |
| (952) 224-9790 |
| Full Name | Family & Cosmetic Gentle Dentistry, Ltd |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 97 85th Ave Nw, Coon Rapids, Minnesota |
| Authorized Official Name and Position | Diana Gavic (OPERATIONS MANAGER) |
| Authorized Official Contact | 9522249771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family & Cosmetic Gentle Dentistry, Ltd 6600 France Ave S Ste 415 Edina MN 55435-1817 Ph: (952) 224-9771 | Family & Cosmetic Gentle Dentistry, Ltd 97 85th Ave Nw Coon Rapids MN 55433-6022 Ph: (952) 224-9771 |
| NPI Number | 1982886859 |
|---|---|
| Provider Enumeration Date | 12/03/2007 |
| Last Update Date | 06/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982886859 | NPI | - | NPPES |
| 783105000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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