Mahtomedi Family Dental

NPI #1720415896 in Mahtomedi, Minnesota

Provider Information

NPI Number: 1720415896
Entity Type: Organization
Organization Name: Mahtomedi Family Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 3, 2013
Last Updated: Oct 3, 2013

Practice Location

Address: 814 MAHTOMEDI AVE
City: Mahtomedi
State: Minnesota
ZIP Code: 55115-1730
Phone: (651) 426-0011

Authorized Official

Name: DR. BRIAN WELLE
Title: DOCTOR
Phone: (651) 426-0011

Specialties & Taxonomy Codes

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

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Bradley John Hagen	Dentist - General Practice	Mahtomedi	AI Deep Dive
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Organizations

Provider Name	Specialty	City
Mahtomedi Dental Clinic Part of Mahtomedi Dental Clinic	Dentist - General Practice	Mahtomedi	AI Deep Dive
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