| St. Croix Endodontics, P.a. | |
|
11945 Central Ave Ne Blaine MN 55434-3911 | |
| (763) 767-9119 | |
| (763) 755-3797 |
| Full Name | St. Croix Endodontics, P.a. |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 11945 Central Ave Ne, Blaine, Minnesota |
| Authorized Official Name and Position | Edward J Stec (OWNER) |
| Authorized Official Contact | 7637679119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Croix Endodontics, P.a. 25 Lake St N Ste 110 Forest Lake MN 55025-2535 Ph: (651) 464-7388 | St. Croix Endodontics, P.a. 11945 Central Ave Ne Blaine MN 55434-3911 Ph: (763) 767-9119 |
| NPI Number | 1629199617 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629199617 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 9920 (Minnesota) | Primary |
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