| Tailwind Pediatric Dentistry | |
|
6945 Penn Ave S Suite 102 Richfield MN 55423-2081 | |
| (612) 866-4041 | |
| Not Available |
| Full Name | Tailwind Pediatric Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6945 Penn Ave S, Richfield, Minnesota |
| Authorized Official Name and Position | Taylor J Stephens (PRESIDENT/OWNER) |
| Authorized Official Contact | 9524753135 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tailwind Pediatric Dentistry 250 Central Ave N Suite 113 Wayzata MN 55391-1206 Ph: (952) 475-3135 | Tailwind Pediatric Dentistry 6945 Penn Ave S Suite 102 Richfield MN 55423-2081 Ph: (612) 866-4041 |
| NPI Number | 1063752483 |
|---|---|
| Provider Enumeration Date | 02/21/2013 |
| Last Update Date | 01/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063752483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D12818 (Minnesota) | Primary |
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