| University Ave Dental, Pllc | |
|
10155 University Ave Ne Ste 112 Blaine MN 55434-8058 | |
| (763) 784-1242 | |
| Not Available |
| Full Name | University Ave Dental, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10155 University Ave Ne Ste 112, Blaine, Minnesota |
| Authorized Official Name and Position | Marty Spanish (OWNER) |
| Authorized Official Contact | 9528367924 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| University Ave Dental, Pllc 10155 University Ave Ne Ste 112 Blaine MN 55434-8058 Ph: (763) 784-1242 | University Ave Dental, Pllc 10155 University Ave Ne Ste 112 Blaine MN 55434-8058 Ph: (763) 784-1242 |
| NPI Number | 1093468852 |
|---|---|
| Provider Enumeration Date | 02/01/2022 |
| Last Update Date | 02/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093468852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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