| Ideal Dental Pllc | |
|
2130 Cliff Rd Ste 107 Eagan MN 55122-2486 | |
| (651) 452-3112 | |
| Not Available |
| Full Name | Ideal Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2130 Cliff Rd Ste 107, Eagan, Minnesota |
| Authorized Official Name and Position | Trent Mitchel Anderson (PARTNER/OWNER) |
| Authorized Official Contact | 6513536651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Dental Pllc 7810 Saint Croix Trail Ln S Hastings MN 55033-9737 Ph: (651) 353-6651 | Ideal Dental Pllc 2130 Cliff Rd Ste 107 Eagan MN 55122-2486 Ph: (651) 452-3112 |
| NPI Number | 1730734708 |
|---|---|
| Provider Enumeration Date | 08/07/2019 |
| Last Update Date | 08/07/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730734708 | NPI | - | NPPES |
| 1689663148 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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