| Andover Family Dentistry | |
|
3480 Bunker Lake Blvd Nw Suite 202 Andover MN 55304 | |
| (763) 427-4780 | |
| (763) 427-8471 |
| Full Name | Andover Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3480 Bunker Lake Blvd Nw, Andover, Minnesota |
| Authorized Official Name and Position | Ethan R Chute (PRESIDENT) |
| Authorized Official Contact | 7634274780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Andover Family Dentistry 3480 Bunker Lake Blvd Nw Suite 202 Andover MN 55304 Ph: (763) 427-4780 | Andover Family Dentistry 3480 Bunker Lake Blvd Nw Suite 202 Andover MN 55304 Ph: (763) 427-4780 |
| NPI Number | 1730256132 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 06/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730256132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D11439 (Minnesota) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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