| Minnesota Dental Professionals, P.c. | |
|
14050 Pilot Knob Rd Ste 108 Apple Valley MN 55124-6648 | |
| (952) 423-4414 | |
| Not Available |
| Full Name | Minnesota Dental Professionals, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 14050 Pilot Knob Rd Ste 108, Apple Valley, Minnesota |
| Authorized Official Name and Position | Tabatha Lemke (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175406078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Dental Professionals, P.c. 14050 Pilot Knob Rd Ste 108 Apple Valley MN 55124-6648 Ph: () - | Minnesota Dental Professionals, P.c. 14050 Pilot Knob Rd Ste 108 Apple Valley MN 55124-6648 Ph: (952) 423-4414 |
| NPI Number | 1154926939 |
|---|---|
| Provider Enumeration Date | 12/01/2020 |
| Last Update Date | 12/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154926939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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