| Matthew P Dale Dds Pa | |
|
13998 Maple Knoll Way # Ll103 Maple Grove MN 55369-7004 | |
| (763) 425-2072 | |
| (763) 425-1487 |
| Full Name | Matthew P Dale Dds Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13998 Maple Knoll Way # Ll103, Maple Grove, Minnesota |
| Authorized Official Name and Position | Matthew Patrick Dale (PRESIDENT) |
| Authorized Official Contact | 7632452072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew P Dale Dds Pa 13998 Maple Knoll Way # Ll103 Maple Grove MN 55369-7004 Ph: (763) 425-2072 | Matthew P Dale Dds Pa 13998 Maple Knoll Way # Ll103 Maple Grove MN 55369-7004 Ph: (763) 425-2072 |
| NPI Number | 1124230800 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 08/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124230800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D10980 (Minnesota) | Primary |
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