| Southridge Dental, Pa | |
|
1320 Mendota Rd Inver Grove Heights MN 55077-1255 | |
| (651) 451-1884 | |
| (651) 306-9709 |
| Full Name | Southridge Dental, Pa |
|---|---|
| Speciality | Dentist |
| Location | 1320 Mendota Rd, Inver Grove Heights, Minnesota |
| Authorized Official Name and Position | Sheryl Bottjen Tandon (DENTIST) |
| Authorized Official Contact | 6514511884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southridge Dental, Pa 1320 Mendota Rd Inver Grove Heights MN 55077-1255 Ph: (651) 451-1884 | Southridge Dental, Pa 1320 Mendota Rd Inver Grove Heights MN 55077-1255 Ph: (651) 451-1884 |
| NPI Number | 1386166734 |
|---|---|
| Provider Enumeration Date | 07/07/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386166734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D12847 (Minnesota) | Primary |
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