Northpark Dental

NPI #1710161500 in Blaine, Minnesota

Provider Information

NPI Number: 1710161500
Entity Type: Organization
Organization Name: Northpark Dental
Primary Specialty: Dentist
Enumeration Date: Dec 28, 2007
Last Updated: Dec 28, 2007

Practice Location

Address: 9120 BALTIMORE ST NE
City: Blaine
State: Minnesota
ZIP Code: 55449-4337
Phone: (763) 786-1560

Authorized Official

Name: PAUL WAYNE CHADBOURN, DDS
Title: PRESIDENT
Phone: (763) 786-1560

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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