| Family & Cosmetic Gentle Dentistry, Ltd | |
|
1680 Suburban Ave Saint Paul MN 55106-6632 | |
| (651) 209-3139 | |
| (651) 209-3138 |
| Full Name | Family & Cosmetic Gentle Dentistry, Ltd |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1680 Suburban Ave, Saint Paul, 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 #415 Edina MN 55435-1805 Ph: (952) 224-9771 | Family & Cosmetic Gentle Dentistry, Ltd 1680 Suburban Ave Saint Paul MN 55106-6632 Ph: (651) 209-3139 |
| NPI Number | 1013199561 |
|---|---|
| Provider Enumeration Date | 11/27/2007 |
| Last Update Date | 06/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013199561 | NPI | - | NPPES |
| 997903100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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