| Nicollet Dental | |
|
6101 Nicollet Ave. So. Minneapolis MN 55419 | |
| (612) 866-8550 | |
| (612) 866-9453 |
| Full Name | Nicollet Dental |
|---|---|
| Speciality | Dentist |
| Location | 6101 Nicollet Ave. So., Minneapolis, Minnesota |
| Authorized Official Name and Position | Casey Lee Nelson (OWNER) |
| Authorized Official Contact | 6128668550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicollet Dental 6101 Nicollet Ave. So. Minneapolis MN 55419 Ph: (612) 866-8550 | Nicollet Dental 6101 Nicollet Ave. So. Minneapolis MN 55419 Ph: (612) 866-8550 |
| NPI Number | 1003108895 |
|---|---|
| Provider Enumeration Date | 05/11/2011 |
| Last Update Date | 05/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003108895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D12104 (Minnesota) | Primary |
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