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Organization
MAPLE GROVE CENTER FOR RESTORATIVE SURGERY LLC
Active
Organization
MAPLE GROVE CENTER FOR RESTORATIVE SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL HANSON (MEDICAL DIRECTOR)
(651) 324-8693
Entity
Organization
Contact information
Practice address
13601 80TH CIRCLE NORTH, SUITE 100, MAPLE GROVE, MN 55369
(763) 432-7655
(763) 432-7501
Mailing address
13601 80TH CIRCLE NORTH, SUITE 100, MAPLE GROVE, MN 55369
(763) 432-7655
(763) 432-7501
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
679516700023
MN
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/18/2014
Last updated
12/19/2019
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