Minnesota Dental Professionals, P.c.
NPI #1619451192 in Forest Lake, Minnesota
Provider Information
- NPI Number
- 1619451192
- Entity Type
- Organization
- Organization Name
- Minnesota Dental Professionals, P.c.
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MINNESOTA DENTAL PROFESSIONALS, P.C.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 20, 2018
- Last Updated
- Dec 17, 2018
Practice Location
- Address
- 107 12TH ST SW STE 2
- City
- Forest Lake
- State
- Minnesota
- ZIP Code
- 55025-1467
- Phone
- (612) 261-4998
Authorized Official
- Name
- JESSICA BRITT
- Title
- CREDENTIALING COORDINATOR
- Phone
- (217) 540-8426
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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