| Tangletown Dental Llc | |
|
4831 Nicollet Ave Minneapolis MN 55419-5534 | |
| (612) 822-2324 | |
| (612) 822-6763 |
| Full Name | Tangletown Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4831 Nicollet Ave, Minneapolis, Minnesota |
| Authorized Official Name and Position | Jan A Nielsen (OFFICE MANAGER) |
| Authorized Official Contact | 6128222324 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tangletown Dental Llc 4831 Nicollet Ave Minneapolis MN 55419-5534 Ph: (612) 822-2324 | Tangletown Dental Llc 4831 Nicollet Ave Minneapolis MN 55419-5534 Ph: (612) 822-2324 |
| NPI Number | 1558776815 |
|---|---|
| Provider Enumeration Date | 06/25/2014 |
| Last Update Date | 06/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558776815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 8320 (Minnesota) | Primary |
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