| Midwest Dental - White Bear Lake | |
|
4520 Centerville Rd Saint Paul MN 55127-3602 | |
| (651) 426-4799 | |
| (651) 426-8106 |
| Full Name | Midwest Dental - White Bear Lake |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4520 Centerville Rd, Saint Paul, Minnesota |
| Authorized Official Name and Position | Chad Hendricks (DIRECTOR, PAYER STRATEGY) |
| Authorized Official Contact | 6123516876 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Dental - White Bear Lake 680 Hehli Way Mondovi WI 54755-1639 Ph: (715) 598-2311 | Midwest Dental - White Bear Lake 4520 Centerville Rd Saint Paul MN 55127-3602 Ph: (651) 426-4799 |
| NPI Number | 1295238178 |
|---|---|
| Provider Enumeration Date | 03/16/2018 |
| Last Update Date | 03/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295238178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Minnesota) | Primary |
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