G2 South Pllc

NPI #1023127388 in Inver Grove Heights, Minnesota

Provider Information

NPI Number: 1023127388
Entity Type: Organization
Organization Name: G2 South Pllc
Primary Specialty: Dentist
Enumeration Date: Aug 30, 2006
Last Updated: Aug 13, 2008

Practice Location

Address: 5846 BLACKSHIRE PATH
City: Inver Grove Heights
State: Minnesota
ZIP Code: 55076
Phone: (651) 389-1133

Authorized Official

Name: TRACEY MICHELLE KOCH
Title: PRACTICE DIRECTOR
Phone: (651) 464-2248

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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