| Prosthodontic Associates, Pllc | |
|
2233 Hamline Ave N Suite 210 Roseville MN 55113-5009 | |
| (651) 633-4914 | |
| (651) 633-5126 |
| Full Name | Prosthodontic Associates, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2233 Hamline Ave N, Roseville, Minnesota |
| Authorized Official Name and Position | Jason Chong (PARTNER) |
| Authorized Official Contact | 6516334914 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prosthodontic Associates, Pllc 2233 Hamline Ave N Suite 210 Roseville MN 55113-5009 Ph: (651) 633-4914 | Prosthodontic Associates, Pllc 2233 Hamline Ave N Suite 210 Roseville MN 55113-5009 Ph: (651) 633-4914 |
| NPI Number | 1164956694 |
|---|---|
| Provider Enumeration Date | 04/11/2017 |
| Last Update Date | 04/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164956694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D12653 (Minnesota) | Primary |
Northland Dental Partners, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2690 Snelling Ave N Ste 200, Roseville, MN 55113 Phone: 651-633-1834 Fax: 651-633-0995 | |
Michael J. Petersen, D.d.s., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3101 Old Highway 8 Ste 303, Roseville, MN 55113 Phone: 651-636-0840 | |