| Mint Dental Shakopee Pllc | |
|
205 Lewis St S Ste 101 Shakopee MN 55379-2290 | |
| (952) 445-3349 | |
| Not Available |
| Full Name | Mint Dental Shakopee Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 205 Lewis St S Ste 101, Shakopee, Minnesota |
| Authorized Official Name and Position | Marwa Gamam-forest (DENTIST) |
| Authorized Official Contact | 9528311332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mint Dental Shakopee Pllc 205 Lewis St S Ste 101 Shakopee MN 55379-2290 Ph: (952) 445-3349 | Mint Dental Shakopee Pllc 205 Lewis St S Ste 101 Shakopee MN 55379-2290 Ph: (952) 445-3349 |
| NPI Number | 1689149775 |
|---|---|
| Provider Enumeration Date | 10/04/2018 |
| Last Update Date | 10/04/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689149775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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