Mahtomedi Family Dental | |
814 Mahtomedi Ave Mahtomedi MN 55115-1730 | |
(651) 426-0011 | |
Not Available |
Full Name | Mahtomedi Family Dental |
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Speciality | Dentist - General Practice |
Location | 814 Mahtomedi Ave, Mahtomedi, Minnesota |
Authorized Official Name and Position | Brian Welle (DOCTOR) |
Authorized Official Contact | 6514260011 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mahtomedi Family Dental 814 Mahtomedi Ave Mahtomedi MN 55115-1730 Ph: () - | Mahtomedi Family Dental 814 Mahtomedi Ave Mahtomedi MN 55115-1730 Ph: (651) 426-0011 |
NPI Number | 1720415896 |
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Provider Enumeration Date | 10/03/2013 |
Last Update Date | 10/03/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720415896 | NPI | - | NPPES |
1811212624 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | D7721 (Minnesota) | Primary |
Mahtomedi Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 814 Mahtomedi Ave, Mahtomedi, MN 55115 Phone: 651-426-0011 Fax: 651-426-2075 | |
North St. Paul Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 814 Mahtomedi Ave, Mahtomedi Dental, Mahtomedi, MN 55115 Phone: 651-426-0011 Fax: 651-426-2075 | |
Orchard Dental Group, P.l.l.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12 Long Lake Rd # 12, Mahtomedi, MN 55115 Phone: 651-770-2699 Fax: 651-770-9896 |