Oak Park Dental Clinic

NPI #1508036070 in Pine City, Minnesota

Provider Information

NPI Number: 1508036070
Entity Type: Organization
Organization Name: Oak Park Dental Clinic
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 11, 2008
Last Updated: Mar 12, 2008

Practice Location

Address: 505 JOHNSON AVE SE
City: Pine City
State: Minnesota
ZIP Code: 55063-2108
Phone: (320) 629-2282

Authorized Official

Name: DR. JON E CRUZ, D.D.S.
Title: DENTIST/OWNER
Phone: (320) 629-2282

Specialties & Taxonomy Codes

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

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