| Twin Cities Sedation Dental, P.a. | |
|
808 W Broadway Ave Suite A Forest Lake MN 55025-3769 | |
| (651) 674-7096 | |
| Not Available |
| Full Name | Twin Cities Sedation Dental, P.a. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 808 W Broadway Ave, Forest Lake, Minnesota |
| Authorized Official Name and Position | Sarah M Burt (OPERATIONS DIRECTOR) |
| Authorized Official Contact | 6516747096 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Twin Cities Sedation Dental, P.a. 6460 Main St North Branch MN 55056-7068 Ph: (651) 674-7096 | Twin Cities Sedation Dental, P.a. 808 W Broadway Ave Suite A Forest Lake MN 55025-3769 Ph: (651) 674-7096 |
| NPI Number | 1932505583 |
|---|---|
| Provider Enumeration Date | 11/10/2014 |
| Last Update Date | 11/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932505583 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Travis W. Wille, Dds, Ms Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 25 Lake St N, Suite 135, Forest Lake, MN 55025 Phone: 651-464-1151 Fax: 651-464-0620 | |
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