G2 South

NPI #1821079583 in Inver Grove Heights, Minnesota

Provider Information

NPI Number: 1821079583
Entity Type: Organization
Organization Name: G2 South
Primary Specialty: Dentist
Enumeration Date: Nov 9, 2005
Last Updated: Aug 22, 2020

Practice Location

Address: 5846 BLACKSHIRE PATH
City: Inver Grove Heights
State: Minnesota
ZIP Code: 55016
Phone: (651) 389-1133

Authorized Official

Name: MS. TRACEY M KOCTT
Title: PRACTICE MANAGER
Phone: (651) 389-1133

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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