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5901 John Martin Dr Brooklyn Center MN 55430-2509 | |
| (763) 566-3770 | |
| (763) 569-1404 |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5901 John Martin Dr, Brooklyn Center, Minnesota |
| Authorized Official Name and Position | Kathleen M Cooney (CAO) |
| Authorized Official Contact | 9528837565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8100 34th Ave S 21113a Bloomington MN 55425-1672 Ph: (952) 883-5151 | 5901 John Martin Dr Brooklyn Center MN 55430-2509 Ph: (763) 566-3770 |
| NPI Number | 1073667051 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073667051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
Northland Dental Partners, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 512 66th Ave N, Brooklyn Center, MN 55430 Phone: 763-560-3334 Fax: 763-560-2191 | |