| The Dental Specialist Of Minnesota, Pllc | |
|
13961 60th St N Stillwater MN 55082-1053 | |
| (651) 760-3681 | |
| (651) 760-3683 |
| Full Name | The Dental Specialist Of Minnesota, Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 13961 60th St N, Stillwater, Minnesota |
| Authorized Official Name and Position | Shannon Hesse (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 6517462815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Dental Specialist Of Minnesota, Pllc 2200 County Road C W Ste 2210 Roseville MN 55113-2551 Ph: () - | The Dental Specialist Of Minnesota, Pllc 13961 60th St N Stillwater MN 55082-1053 Ph: (651) 760-3681 |
| NPI Number | 1265097653 |
|---|---|
| Provider Enumeration Date | 05/01/2019 |
| Last Update Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265097653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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