Integra Dental PA

NPI #1508201997 in Andover, Minnesota

Provider Information

NPI Number: 1508201997
Entity Type: Organization
Organization Name: Integra Dental PA
Primary Specialty: Dentist
Enumeration Date: Apr 30, 2013
Last Updated: Apr 30, 2013

Practice Location

Address: 13783 IBIS ST NW
Address 2: SUITE 400
City: Andover
State: Minnesota
ZIP Code: 55304-4892
Phone: (612) 384-0527

Authorized Official

Name: DR. GINA L ANDERSLAND, D.D.S.
Title: OWNER/DENTIST
Phone: (612) 384-0527

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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