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Organization
SHINE DENTAL LLC
Active
Organization
SHINE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAHADO ONWUKWE (AUTHORIZED OFFICIAL)
(320) 980-6031
Entity
Organization
Contact information
Practice address
1020 4TH ST SE STE 200, SAINT CLOUD, MN 56304-1245
(320) 980-6031
Mailing address
1020 4TH ST SE STE 200, SAINT CLOUD, MN 56304-1245
(320) 980-6031
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/17/2026
Last updated
08/17/2026
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