| Luna Land Dental Corp. | |
|
4080 W Broadway Ave Ste 300 Robbinsdale MN 55422-5607 | |
| (651) 292-9331 | |
| Not Available |
| Full Name | Luna Land Dental Corp. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4080 W Broadway Ave Ste 300, Robbinsdale, Minnesota |
| Authorized Official Name and Position | David J Park (CEO/PRESIDENT) |
| Authorized Official Contact | 6517887045 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luna Land Dental Corp. 4080 W Broadway Ave Ste 300 Robbinsdale MN 55422-5607 Ph: (651) 292-9331 | Luna Land Dental Corp. 4080 W Broadway Ave Ste 300 Robbinsdale MN 55422-5607 Ph: (651) 292-9331 |
| NPI Number | 1770056426 |
|---|---|
| Provider Enumeration Date | 01/05/2019 |
| Last Update Date | 01/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770056426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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