| Orthodontics | |
|
515 Delaware St Se 6th Floor Moos Tower Minneapolis MN 55455-0357 | |
| (612) 625-6444 | |
| Not Available |
| Full Name | Orthodontics |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 515 Delaware St Se, Minneapolis, Minnesota |
| Authorized Official Name and Position | Gary Carl Anderson (DEAN, UOFMN SCHOOL OF DENTISTRY) |
| Authorized Official Contact | 6126266529 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orthodontics 515 Delaware St Se 7-530 Moos Tower Minneapolis MN 55455-0357 Ph: (612) 626-6529 | Orthodontics 515 Delaware St Se 6th Floor Moos Tower Minneapolis MN 55455-0357 Ph: (612) 625-6444 |
| NPI Number | 1588782197 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 12/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588782197 | NPI | - | NPPES |
| 778172200 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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