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9145 Springbrook Dr Nw Suite 100 Coon Rapids MN 55433-5885 | |
| (763) 201-6962 | |
| (763) 786-8673 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 9145 Springbrook Dr Nw, Coon Rapids, Minnesota |
| Authorized Official Name and Position | Alan Law (PRESIDENT) |
| Authorized Official Contact | 6516330500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2200 County Road C W Suite 2210 Roseville MN 55113-2550 Ph: (651) 633-0500 | 9145 Springbrook Dr Nw Suite 100 Coon Rapids MN 55433-5885 Ph: (763) 201-6962 |
| NPI Number | 1518200286 |
|---|---|
| Provider Enumeration Date | 04/01/2013 |
| Last Update Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518200286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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