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Organization
SHAKOPEE VALLEY FAMILY DENTAL CARE, P.A.
Active
Organization
SHAKOPEE VALLEY FAMILY DENTAL CARE, P.A.
Active
Other names
Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN CHARLES PERRY DDS (OWNER)
(952) 445-5510
Entity
Organization
Contact information
Practice address
415 1ST AVE E, SHAKOPEE, MN 55379-1439
(952) 445-5510
(952) 496-9728
Mailing address
415 1ST AVE E, SHAKOPEE, MN 55379-1439
(952) 445-5510
(952) 496-9728
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8975
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659332252
TYPE I NPI NUMBER
MN
Enumeration date
12/21/2008
Last updated
12/21/2008
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