Northern Orthodontics

NPI #1659670362 in Fridley, Minnesota

Provider Information

NPI Number: 1659670362
Entity Type: Organization
Organization Name: Northern Orthodontics
Subpart: Yes (part of a larger organization)
Parent Organization: ST. CROIX VALLEY DENTAL, PLLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Mar 21, 2011
Last Updated: Mar 21, 2011

Practice Location

Address: 1109 EAST MOORE LAKE DRIVE
City: Fridley
State: Minnesota
ZIP Code: 55432
Phone: (651) 439-2600

Authorized Official

Name: DR. DOUG S WOLFF, D.D.S.
Title: OWNER
Phone: (651) 439-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Clinic/Center - Dental — Dental	261QD0000X	Primary

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