| Northdale Dentist Pa | |
|
2147, Northdale Blvd Nw. Coon Rapids MN 55433 | |
| (763) 497-6977 | |
| (763) 463-7807 |
| Full Name | Northdale Dentist Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2147, Northdale Blvd Nw., Coon Rapids, Minnesota |
| Authorized Official Name and Position | Jagannatian Ramakrishnan (DENTIST) |
| Authorized Official Contact | 7632182887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northdale Dentist Pa 6808, 67th Street Ne. Albertville MN 55301 Ph: (763) 218-2887 | Northdale Dentist Pa 2147, Northdale Blvd Nw. Coon Rapids MN 55433 Ph: (763) 497-6977 |
| NPI Number | 1619287562 |
|---|---|
| Provider Enumeration Date | 10/13/2010 |
| Last Update Date | 10/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619287562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D12003 (Minnesota) | Primary |
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