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Organization
ALTERNATIVE DENTAL NETWORK
Active
Organization
ALTERNATIVE DENTAL NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVERN THOMAS (ADMINISTRATOR)
(612) 280-0350
Entity
Organization
Contact information
Practice address
8014 HWY 55, STE 154, GOLDEN VALLEY, MN 55427
(612) 280-0350
Mailing address
8014 HIGHWAY 55, # 154, GOLDEN VALLEY, MN 55427-4712
(612) 280-0350
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
MN
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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