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Organization
MINNESOTA DENTAL PROFESSIONALS, P.C.
Active
Organization
MINNESOTA DENTAL PROFESSIONALS, P.C.
Active
Parent organization
MINNESOTA DENTAL PROFESSIONALS, P.C.
Other names
Foley Dental Office
Organization subpart
Yes
Provider details
NPI number
Legal business name
MINNESOTA DENTAL PROFESSIONALS, P.C.
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization
Contact information
Practice address
11237 FOLEY BLVD NW, COON RAPIDS, MN 55448-3389
(763) 757-1234
Mailing address
11237 FOLEY BLVD NW, COON RAPIDS, MN 55448-3389
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/24/2019
Last updated
09/24/2019
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