| Mn Dental Service Providers Llc | |
|
3833 Coon Rapids Blvd Nw Coon Rapids MN 55433-2643 | |
| (763) 421-6271 | |
| Not Available |
| Full Name | Mn Dental Service Providers Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3833 Coon Rapids Blvd Nw, Coon Rapids, Minnesota |
| Authorized Official Name and Position | Charlotte E Vial (DIREC OF CRED AND PROV REL) |
| Authorized Official Contact | 5046380303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mn Dental Service Providers Llc 1610 54th Ave N Ste 205 Nashville TN 37209-1442 Ph: (615) 678-0759 | Mn Dental Service Providers Llc 3833 Coon Rapids Blvd Nw Coon Rapids MN 55433-2643 Ph: (763) 421-6271 |
| NPI Number | 1649043662 |
|---|---|
| Provider Enumeration Date | 11/01/2023 |
| Last Update Date | 11/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649043662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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