| Minnesota Dental Group | |
|
4125 Lakeland Ave N 100 Robbinsdale MN 55422-1852 | |
| (763) 537-5123 | |
| Not Available |
| Full Name | Minnesota Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4125 Lakeland Ave N, Robbinsdale, Minnesota |
| Authorized Official Name and Position | Carl Benton Fitzsimmons (PRESIDENT) |
| Authorized Official Contact | 7635375123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Dental Group 4125 Lakeland Ave N 100 Robbinsdale MN 55422-1852 Ph: (763) 537-5123 | Minnesota Dental Group 4125 Lakeland Ave N 100 Robbinsdale MN 55422-1852 Ph: (763) 537-5123 |
| NPI Number | 1225178361 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225178361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 11044 (Minnesota) | Primary |
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Minnesota Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4125 Lakeland Ave N, Suite 100, Robbinsdale, MN 55422 Phone: 763-537-5123 Fax: 763-533-2034 |