| The Dental Specialists- Orthodontics | |
|
12904 Central Ave Ne Blaine MN 55434 | |
| (763) 201-6960 | |
| Not Available |
| Full Name | The Dental Specialists- Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 12904 Central Ave Ne, Blaine, Minnesota |
| Authorized Official Name and Position | John Gulon (PRESEIDENT) |
| Authorized Official Contact | 6517462815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Dental Specialists- Orthodontics 2200 County Road C W Ste 2210 Roseville MN 55113-2551 Ph: (651) 746-2815 | The Dental Specialists- Orthodontics 12904 Central Ave Ne Blaine MN 55434 Ph: (763) 201-6960 |
| NPI Number | 1902398944 |
|---|---|
| Provider Enumeration Date | 06/05/2018 |
| Last Update Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902398944 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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