| Nokomis Family Dental Pa | |
|
4948 34th Ave S Minneapolis MN 55417-1504 | |
| (612) 722-4676 | |
| Not Available |
| Full Name | Nokomis Family Dental Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4948 34th Ave S, Minneapolis, Minnesota |
| Authorized Official Name and Position | Sam Jacobson (BUSINESS MANAGER) |
| Authorized Official Contact | 9528810504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nokomis Family Dental Pa 8910 Penn Ave S Bloomington MN 55431-2025 Ph: (952) 881-0504 | Nokomis Family Dental Pa 4948 34th Ave S Minneapolis MN 55417-1504 Ph: (612) 722-4676 |
| NPI Number | 1689284481 |
|---|---|
| Provider Enumeration Date | 08/06/2020 |
| Last Update Date | 08/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689284481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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