| Mdo Periodontics Pa | |
|
1900 Kruchten Ct S Ste. 101 Sartell MN 56377-4730 | |
| (320) 240-9028 | |
| (320) 240-9048 |
| Full Name | Mdo Periodontics Pa |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1900 Kruchten Ct S, Sartell, Minnesota |
| Authorized Official Name and Position | Michelle Grundhoefer (OFFICE MANAGER) |
| Authorized Official Contact | 3202409028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mdo Periodontics Pa 1900 Kruchten Ct S Ste. 101 Sartell MN 56377-4730 Ph: (320) 240-9028 | Mdo Periodontics Pa 1900 Kruchten Ct S Ste. 101 Sartell MN 56377-4730 Ph: (320) 240-9028 |
| NPI Number | 1558516369 |
|---|---|
| Provider Enumeration Date | 11/20/2008 |
| Last Update Date | 11/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558516369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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