Family & Cosmetic Gentle Dentistry, Ltd
NPI #1477112456 in Coon Rapids, Minnesota
Provider Information
- NPI Number
- 1477112456
- Entity Type
- Organization
- Organization Name
- Family & Cosmetic Gentle Dentistry, Ltd
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jun 12, 2019
- Last Updated
- Jun 12, 2019
Practice Location
- Address
- 2147 NORTHDALE BLVD NW
- City
- Coon Rapids
- State
- Minnesota
- ZIP Code
- 55433
- Phone
- (651) 209-3139
Authorized Official
- Name
- MR. ROBERT LUTHER BODIN, D.D.S.
- Title
- OWNER/CEO
- Phone
- (952) 224-9788
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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