| Northstar Dental Clinic Pa | |
|
675 E Nicollet Blvd Suite 120 Burnsville MN 55337-6741 | |
| (952) 892-7700 | |
| (952) 892-7767 |
| Full Name | Northstar Dental Clinic Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 675 E Nicollet Blvd, Burnsville, Minnesota |
| Authorized Official Name and Position | Michael Shawn Nanne (OWNER PRESIDENT) |
| Authorized Official Contact | 9528927700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northstar Dental Clinic Pa 675 E Nicollet Blvd Suite 120 Burnsville MN 55337-6741 Ph: (952) 892-7700 | Northstar Dental Clinic Pa 675 E Nicollet Blvd Suite 120 Burnsville MN 55337-6741 Ph: (952) 892-7700 |
| NPI Number | 1043265481 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043265481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10615 (Minnesota) | Primary |
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