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3030 Centre Pointe Dr Suite 100 Roseville MN 55113-1112 | |
| (651) 286-8100 | |
| (651) 633-6811 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3030 Centre Pointe Dr, Roseville, Minnesota |
| Authorized Official Name and Position | James Ludke (CHIEF MANAGER) |
| Authorized Official Contact | 6512868100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3030 Centre Pointe Dr Suite 100 Roseville MN 55113-1112 Ph: (651) 286-8100 | 3030 Centre Pointe Dr Suite 100 Roseville MN 55113-1112 Ph: (651) 286-8100 |
| NPI Number | 1780866962 |
|---|---|
| Provider Enumeration Date | 11/29/2007 |
| Last Update Date | 04/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780866962 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D12311 (Minnesota) | Primary |
Northland Dental Partners, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2690 Snelling Ave N Ste 200, Roseville, MN 55113 Phone: 651-633-1834 Fax: 651-633-0995 | |
Michael J. Petersen, D.d.s., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3101 Old Highway 8 Ste 303, Roseville, MN 55113 Phone: 651-636-0840 | |
Prosthodontic Associates, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2233 Hamline Ave N, Suite 210, Roseville, MN 55113 Phone: 651-633-4914 Fax: 651-633-5126 |