Minnesota Dental Professionals, P.c.

NPI #1114522992 in Eagan, Minnesota

Provider Information

NPI Number: 1114522992
Entity Type: Organization
Organization Name: Minnesota Dental Professionals, P.c.
Subpart: Yes (part of a larger organization)
Parent Organization: HEARTLAND DENTAL
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 1, 2020
Last Updated: Dec 1, 2020

Practice Location

Address: 4555 ERIN DR STE 180
City: Eagan
State: Minnesota
ZIP Code: 55122-3334
Phone: (651) 681-9044

Authorized Official

Name: TABATHA LEMKE
Title: CREDENTIALING COORDINATOR
Phone: (217) 540-6078

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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