| St Croix Valley Dental | |
|
13961 60th St. North Stillwater MN 55082 | |
| (651) 439-2600 | |
| (651) 439-2211 |
| Full Name | St Croix Valley Dental |
|---|---|
| Speciality | Dentist |
| Location | 13961 60th St. North, Stillwater, Minnesota |
| Authorized Official Name and Position | Douglas S Wolff (OWNER) |
| Authorized Official Contact | 6514392600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Croix Valley Dental 13961 60th St. North Stillwater MN 55082 Ph: (651) 439-2600 | St Croix Valley Dental 13961 60th St. North Stillwater MN 55082 Ph: (651) 439-2600 |
| NPI Number | 1740259464 |
|---|---|
| Provider Enumeration Date | 03/15/2006 |
| Last Update Date | 02/22/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740259464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 7898 (Minnesota) | Secondary |
| 122300000X | Dentist | D11236 (Minnesota) | Primary |
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