Minnesota Craniofacial Center P.c. | |
2550 University Ave W Suite 143n Saint Paul MN 55114-1052 | |
(651) 642-1013 | |
(651) 642-0947 |
Full Name | Minnesota Craniofacial Center P.c. |
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Speciality | Clinic/center |
Location | 2550 University Ave W, Saint Paul, Minnesota |
Authorized Official Name and Position | Kim Marie Ledermann (DENTIST/OWNER) |
Authorized Official Contact | 6516421013 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Minnesota Craniofacial Center P.c. 2550 University Ave W Suite 143n Saint Paul MN 55114-1052 Ph: (651) 642-1013 | Minnesota Craniofacial Center P.c. 2550 University Ave W Suite 143n Saint Paul MN 55114-1052 Ph: (651) 642-1013 |
NPI Number | 1104160480 |
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Provider Enumeration Date | 11/26/2012 |
Last Update Date | 06/11/2015 |
Identifier | Type | State | Issuer |
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1104160480 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 11715 (Minnesota) | Primary |
Premiere Mental Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 Sherman St Ste 290, Saint Paul, MN 55102 Phone: 763-913-8125 |