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707 Bielenberg Dr Suite101 Woodbury MN 55125-1426 | |
| (651) 304-6017 | |
| (651) 964-3548 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 707 Bielenberg Dr, Woodbury, Minnesota |
| Authorized Official Name and Position | Avinash Matha (OWNER/DENTIST) |
| Authorized Official Contact | 6519643747 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
707 Bielenberg Dr Suite101 Woodbury MN 55125-1426 Ph: (651) 964-3747 | 707 Bielenberg Dr Suite101 Woodbury MN 55125-1426 Ph: (651) 304-6017 |
| NPI Number | 1811392665 |
|---|---|
| Provider Enumeration Date | 10/22/2014 |
| Last Update Date | 12/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811392665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D11742 (Minnesota) | Primary |
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