Minneapolis-St. Paul Periodontics

NPI #1013216811 in Fridley, Minnesota

Provider Information

NPI Number
1013216811
Entity Type
Organization
Organization Name
Minneapolis-St. Paul Periodontics
Subpart
Yes (part of a larger organization)
Parent Organization
ST. CROIX VALLEY DENTAL
Primary Specialty
Dentist - Periodontics
Enumeration Date
Mar 18, 2011
Last Updated
Mar 18, 2011

Practice Location

Address
1109 EAST MOORE LAKE DRIVE
ZIP Code
55432
Phone
(651) 439-2600

Authorized Official

Name
DR. DOUG S WOLFF, D.D.S.
Title
OWNER
Phone
(651) 439-2600

Specialties & Taxonomy Codes

Specialty
Dentist - PeriodonticsPeriodontics

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