123 Brush Dental LLC
NPI #1053807016 in Maplewood, Minnesota
Provider Information
- NPI Number
- 1053807016
- Entity Type
- Organization
- Organization Name
- 123 Brush Dental LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Jul 2, 2018
- Last Updated
- Jul 2, 2018
Practice Location
Authorized Official
- Name
- DR. VACHAREE SRISWAD PETERSON, DDS
- Title
- DENTIST
- Phone
- (651) 779-4195
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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