| Tonka Smiles | |
|
11601 Minnetonka Mills Rd Ste D40 Minnetonka MN 55305 | |
| (952) 938-8533 | |
| (952) 938-9321 |
| Full Name | Tonka Smiles |
|---|---|
| Speciality | Dentist |
| Location | 11601 Minnetonka Mills Rd, Minnetonka, Minnesota |
| Authorized Official Name and Position | Timothy M Bergsteadt (OWNER DENTIST) |
| Authorized Official Contact | 9529388533 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tonka Smiles 11601 Minnetonka Mills Rd Ste D40 Minnetonka MN 55305 Ph: (952) 938-8533 | Tonka Smiles 11601 Minnetonka Mills Rd Ste D40 Minnetonka MN 55305 Ph: (952) 938-8533 |
| NPI Number | 1780790881 |
|---|---|
| Provider Enumeration Date | 08/22/2006 |
| Last Update Date | 07/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780790881 | NPI | - | NPPES |
| 056216500 | Medicaid | MN | |
| 168135400 | Medicaid | MN | |
| 773218000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8734 (Minnesota) | Primary |
| 122300000X | Dentist | 10769 (Minnesota) | Secondary |
| 122300000X | Dentist | 11571 (Minnesota) | Secondary |
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