| Jain Dental St. Louis Park, Pllc | |
|
4600 Excelsior Blvd St Louis Park MN 55416-4938 | |
| (952) 926-3392 | |
| Not Available |
| Full Name | Jain Dental St. Louis Park, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4600 Excelsior Blvd, St Louis Park, Minnesota |
| Authorized Official Name and Position | Nicholas Bussa (GENERAL DENTIST) |
| Authorized Official Contact | 9529263392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jain Dental St. Louis Park, Pllc 4600 Excelsior Blvd St Louis Park MN 55416-4938 Ph: (952) 926-3392 | Jain Dental St. Louis Park, Pllc 4600 Excelsior Blvd St Louis Park MN 55416-4938 Ph: (952) 926-3392 |
| NPI Number | 1497373195 |
|---|---|
| Provider Enumeration Date | 07/08/2020 |
| Last Update Date | 07/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497373195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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