Central Avenue Dental Care | |
12371 Ulysses St Ne Blaine MN 55434-3910 | |
(763) 203-6100 | |
Not Available |
Full Name | Central Avenue Dental Care |
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Speciality | Dentist - General Practice |
Location | 12371 Ulysses St Ne, Blaine, Minnesota |
Authorized Official Name and Position | Celia Hayes (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 2175402100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Central Avenue Dental Care 12371 Ulysses St Ne Blaine MN 55434-3910 Ph: (763) 203-6100 | Central Avenue Dental Care 12371 Ulysses St Ne Blaine MN 55434-3910 Ph: (763) 203-6100 |
NPI Number | 1619619129 |
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Provider Enumeration Date | 04/13/2022 |
Last Update Date | 02/01/2024 |
Identifier | Type | State | Issuer |
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1619619129 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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