| Pediatric Dentistry P.l.c. | |
|
151 19th St S Sartell MN 56377-2153 | |
| (320) 229-2222 | |
| (888) 563-2069 |
| Full Name | Pediatric Dentistry P.l.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 151 19th St S, Sartell, Minnesota |
| Authorized Official Name and Position | Liliana Lucas (DENTIST) |
| Authorized Official Contact | 3202292222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry P.l.c. 151 19th St S Sartell MN 56377-2153 Ph: () - | Pediatric Dentistry P.l.c. 151 19th St S Sartell MN 56377-2153 Ph: (320) 229-2222 |
| NPI Number | 1780938688 |
|---|---|
| Provider Enumeration Date | 10/31/2012 |
| Last Update Date | 10/31/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780938688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D12500 (Minnesota) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | D12249 (Minnesota) | Secondary |
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