| Tc Orthodontics | |
|
15875 Emperor Avenue Apple Valley MN 55124 | |
| (651) 344-8817 | |
| Not Available |
| Full Name | Tc Orthodontics |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 15875 Emperor Avenue, Apple Valley, Minnesota |
| Authorized Official Name and Position | Chad Holly Kelly (PRESIDENT/OWNER) |
| Authorized Official Contact | 7634201030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tc Orthodontics 4630 Edgebrook Place Edina MN 55424 Ph: (763) 420-1030 | Tc Orthodontics 15875 Emperor Avenue Apple Valley MN 55124 Ph: (651) 344-8817 |
| NPI Number | 1639687189 |
|---|---|
| Provider Enumeration Date | 01/18/2018 |
| Last Update Date | 01/18/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639687189 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 11493 (Minnesota) | Primary |
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