Andover Family Dentistry, LLC

NPI #1730256132 in Andover, Minnesota

Provider Information

NPI Number: 1730256132
Entity Type: Organization
Organization Name: Andover Family Dentistry, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Nov 29, 2006
Last Updated: Jun 19, 2019

Practice Location

Address: 3480 BUNKER LAKE BLVD NW
Address 2: SUITE 202
City: Andover
State: Minnesota
ZIP Code: 55304
Phone: (763) 427-4780

Authorized Official

Name: DR. ETHAN R CHUTE, D.D.S.
Title: PRESIDENT
Phone: (763) 427-4780

Specialties & Taxonomy Codes

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

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