| Northwest Family Dental Center Tn | |
|
12725 43rd St Ne Suite 202 Saint Michael MN 55376-4900 | |
| (763) 497-2367 | |
| (763) 497-8171 |
| Full Name | Northwest Family Dental Center Tn |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12725 43rd St Ne, Saint Michael, Minnesota |
| Authorized Official Name and Position | David A. Desimone (OWNER) |
| Authorized Official Contact | 7634972367 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Family Dental Center Tn 12725 43rd St Ne Suite 202 Saint Michael MN 55376-4900 Ph: (763) 497-2367 | Northwest Family Dental Center Tn 12725 43rd St Ne Suite 202 Saint Michael MN 55376-4900 Ph: (763) 497-2367 |
| NPI Number | 1114130010 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114130010 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8424 (Minnesota) | Primary |
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