| Luna Land Dental, Corp. | |
|
393 Dunlap St N Ste 308 Saint Paul MN 55104-4223 | |
| (651) 788-7045 | |
| Not Available |
| Full Name | Luna Land Dental, Corp. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 393 Dunlap St N Ste 308, Saint Paul, Minnesota |
| Authorized Official Name and Position | David Ji Hyun Park (CEO) |
| Authorized Official Contact | 6517887045 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luna Land Dental, Corp. 393 Dunlap St N Ste 308 Saint Paul MN 55104-4223 Ph: (651) 788-7045 | Luna Land Dental, Corp. 393 Dunlap St N Ste 308 Saint Paul MN 55104-4223 Ph: (651) 788-7045 |
| NPI Number | 1821513375 |
|---|---|
| Provider Enumeration Date | 08/06/2017 |
| Last Update Date | 01/04/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821513375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D13905 (Minnesota) | Primary |
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