| Grove Endodontics, P.a. | |
|
8811 92nd St S Suite 109 Cottage Grove MN 55016-4036 | |
| (651) 768-8180 | |
| (651) 768-8184 |
| Full Name | Grove Endodontics, P.a. |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 8811 92nd St S, Cottage Grove, Minnesota |
| Authorized Official Name and Position | Thomas W Waldron (PRESIDENT) |
| Authorized Official Contact | 6517688180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grove Endodontics, P.a. 8811 92nd St S Suite 109 Cottage Grove MN 55016-4036 Ph: (651) 768-8180 | Grove Endodontics, P.a. 8811 92nd St S Suite 109 Cottage Grove MN 55016-4036 Ph: (651) 768-8180 |
| NPI Number | 1083789507 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083789507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | D10981 (Minnesota) | Primary |
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