| Signature Orthodontics | |
|
2126 5th St White Bear Lake MN 55110-2717 | |
| (651) 426-9986 | |
| (651) 653-4653 |
| Full Name | Signature Orthodontics |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2126 5th St, White Bear Lake, Minnesota |
| Authorized Official Name and Position | Wendy Lee Sydlewski (PRESIDENT) |
| Authorized Official Contact | 6514269986 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Signature Orthodontics 2126 5th St White Bear Lake MN 55110-2717 Ph: (651) 426-9986 | Signature Orthodontics 2126 5th St White Bear Lake MN 55110-2717 Ph: (651) 426-9986 |
| NPI Number | 1326206350 |
|---|---|
| Provider Enumeration Date | 05/27/2008 |
| Last Update Date | 05/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326206350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 10622 (Minnesota) | Primary |
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