Family & Cosmetic Gentle Dentistry
NPI #1790967248 in Spring Park, Minnesota
Provider Information
- NPI Number
- 1790967248
- Entity Type
- Organization
- Organization Name
- Family & Cosmetic Gentle Dentistry
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- FAMILY & COSMETIC GENTLE DENTISTRY
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 27, 2007
- Last Updated
- Jun 20, 2008
Practice Location
- Address
- 4787 SHORELINE DR
- City
- Spring Park
- State
- Minnesota
- ZIP Code
- 55384-9713
- Phone
- (952) 471-0900
Authorized Official
- Name
- DIANA GAVIC
- Title
- OPERATIONS MANAGER
- Phone
- (952) 224-9771
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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