Borealis Dental Wyoming PA

NPI #1750147492 in Wyoming, Minnesota

Provider Information

NPI Number: 1750147492
Entity Type: Organization
Organization Name: Borealis Dental Wyoming PA
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 21, 2024
Last Updated: Nov 5, 2024

Practice Location

Address: 26357 FOREST BLVD # 2
City: Wyoming
State: Minnesota
ZIP Code: 55092-8353
Phone: (651) 462-7017

Authorized Official

Name: SEAN GOOLSBY, DDS
Title: PRESIDENT
Phone: (651) 757-0482

Specialties & Taxonomy Codes

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

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