Minnesota Craniofacial Center P.c.
NPI #1104160480 in Saint Paul, Minnesota
Provider Information
- NPI Number
- 1104160480
- Entity Type
- Organization
- Organization Name
- Minnesota Craniofacial Center P.c.
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Nov 26, 2012
- Last Updated
- Jun 11, 2015
Practice Location
- Address
- 2550 UNIVERSITY AVE W
- Address 2
- SUITE 143N
- City
- Saint Paul
- State
- Minnesota
- ZIP Code
- 55114-1052
- Phone
- (651) 642-1013
Authorized Official
- Name
- DR. KIM MARIE LEDERMANN, D.D.S.
- Title
- DENTIST/OWNER
- Phone
- (651) 642-1013
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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