| Minnesota Dental Professionals, P.c. | |
|
12000 Elm Creek Blvd N Ste 230 Maple Grove MN 55369-7075 | |
| (763) 251-5280 | |
| Not Available |
| Full Name | Minnesota Dental Professionals, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12000 Elm Creek Blvd N Ste 230, Maple Grove, Minnesota |
| Authorized Official Name and Position | Tabatha Lemke (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175406078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnesota Dental Professionals, P.c. 12000 Elm Creek Blvd N Ste 230 Maple Grove MN 55369-7075 Ph: (763) 251-5280 | Minnesota Dental Professionals, P.c. 12000 Elm Creek Blvd N Ste 230 Maple Grove MN 55369-7075 Ph: (763) 251-5280 |
| NPI Number | 1306424197 |
|---|---|
| Provider Enumeration Date | 04/01/2021 |
| Last Update Date | 04/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306424197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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