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515 Delaware St Se 7-530 Moos Tower Minneapolis MN 55455-0369 | |
(613) 262-6423 | |
(612) 626-1972 |
Full Name | |
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Speciality | Dentist |
Location | 515 Delaware St Se, Minneapolis, Minnesota |
Authorized Official Name and Position | Jeffrey S. Ogden (CHIEF ADMINISTRATIVE OFFICER) |
Authorized Official Contact | 6126246624 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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515 Delaware St Se 7-530 Moos Tower Minneapolis MN 55455-0369 Ph: (613) 262-6423 | 515 Delaware St Se 7-530 Moos Tower Minneapolis MN 55455-0369 Ph: (613) 262-6423 |
NPI Number | 1952712366 |
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Provider Enumeration Date | 05/20/2014 |
Last Update Date | 05/20/2014 |
Identifier | Type | State | Issuer |
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1952712366 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (Minnesota) | Primary |
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