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100 S 5th St Ste 1900 Minneapolis MN 55402-1267 | |
| (844) 882-3127 | |
| (844) 246-5875 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 100 S 5th St Ste 1900, Minneapolis, Minnesota |
| Authorized Official Name and Position | John Maroney (CEO) |
| Authorized Official Contact | 8448823127 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2100 E Lake Cook Rd Ste 1000 Buffalo Grove IL 60089-1999 Ph: (844) 882-3127 | 100 S 5th St Ste 1900 Minneapolis MN 55402-1267 Ph: (844) 882-3127 |
| NPI Number | 1124677133 |
|---|---|
| Provider Enumeration Date | 09/11/2019 |
| Last Update Date | 09/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124677133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 231H00000X | Audiologist | (* (Not Available)) | Secondary |
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Minneapolis Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 S 5th St Ste 1475, Minneapolis, MN 55402 Phone: 612-332-1255 Fax: 612-388-3721 |