| Healthpartners Plymouth Dental Clinic | |
|
4155 County Rd 101 N Plymouth MN 55446-2308 | |
| (952) 977-3000 | |
| Not Available |
| Full Name | Healthpartners Plymouth Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4155 County Rd 101 N, Plymouth, Minnesota |
| Authorized Official Name and Position | David S Gesko (SENIOR VP/DENTAL DIRECTOR) |
| Authorized Official Contact | 9528837577 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthpartners Plymouth Dental Clinic 8170 33rd Ave S Bloomington MN 55425-4516 Ph: (952) 883-5151 | Healthpartners Plymouth Dental Clinic 4155 County Rd 101 N Plymouth MN 55446-2308 Ph: (952) 977-3000 |
| NPI Number | 1558764597 |
|---|---|
| Provider Enumeration Date | 10/06/2014 |
| Last Update Date | 10/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558764597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12465 (Minnesota) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 12245 (Minnesota) | Secondary |
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