| K.o.a.l.a. Dental Care, Llc | |
|
1521 Northway Dr Suite 108 Saint Cloud MN 56303-4489 | |
| (320) 253-8380 | |
| (320) 253-8419 |
| Full Name | K.o.a.l.a. Dental Care, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1521 Northway Dr, Saint Cloud, Minnesota |
| Authorized Official Name and Position | John David Collier (OWNER) |
| Authorized Official Contact | 3202538380 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| K.o.a.l.a. Dental Care, Llc 20 1st Ave S Buffalo MN 55313-1409 Ph: (320) 253-8380 | K.o.a.l.a. Dental Care, Llc 1521 Northway Dr Suite 108 Saint Cloud MN 56303-4489 Ph: (320) 253-8380 |
| NPI Number | 1710317326 |
|---|---|
| Provider Enumeration Date | 11/18/2013 |
| Last Update Date | 11/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710317326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D11694 (Minnesota) | Primary |
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