| Wise Option Dental Pllc | |
|
10653 Wayzata Blvd Ste 200 Minnetonka MN 55305-1543 | |
| (612) 578-8893 | |
| Not Available |
| Full Name | Wise Option Dental Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 10653 Wayzata Blvd Ste 200, Minnetonka, Minnesota |
| Authorized Official Name and Position | Kirby Johnson (OWNER/PRESIDENT) |
| Authorized Official Contact | 6128342512 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wise Option Dental Pllc 320 Calamus Cir Medina MN 55340-9228 Ph: () - | Wise Option Dental Pllc 10653 Wayzata Blvd Ste 200 Minnetonka MN 55305-1543 Ph: (612) 578-8893 |
| NPI Number | 1407613375 |
|---|---|
| Provider Enumeration Date | 03/06/2024 |
| Last Update Date | 03/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407613375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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