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Organization
MINNESOTA DENTAL SURGERY PLLC
Active
Organization
MINNESOTA DENTAL SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENNETT ISABELLA DDS (CEO)
(952) 215-7419
Entity
Organization
Contact information
Practice address
9801 DUPONT AVE S, BLOOMINGTON, MN 55431-3100
(952) 215-7419
Mailing address
3510 120TH ST W, ROSEMOUNT, MN 55068-3501
(952) 215-7419
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D12540
MN
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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