| Plymouth Plaza Dental | |
|
1495 County Road 101 N Suite2 Plymouth MN 55447-3078 | |
| (763) 476-6774 | |
| (763) 476-2147 |
| Full Name | Plymouth Plaza Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1495 County Road 101 N, Plymouth, Minnesota |
| Authorized Official Name and Position | Janet Ann Nielsen (OFFICE MANAGER) |
| Authorized Official Contact | 7634766774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Plymouth Plaza Dental 1495 County Road 101 N Suite2 Plymouth MN 55447-3078 Ph: (763) 476-6774 | Plymouth Plaza Dental 1495 County Road 101 N Suite2 Plymouth MN 55447-3078 Ph: (763) 476-6774 |
| NPI Number | 1609095140 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609095140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8320 (Minnesota) | Primary |
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