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Organization
GREENHAVEN FAMILY DENTAL
Active
Organization
GREENHAVEN FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLINTON L ROBERTS DDS (OWNER)
(218) 454-0523
Entity
Organization
Contact information
Practice address
13495 ELDER DR, SUITE 100, BAXTER, MN 56425-8763
(218) 454-0523
(218) 454-0524
Mailing address
13495 ELDER DR, SUITE 100, BAXTER, MN 56425-8763
(218) 454-0523
(218) 454-0524
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10518
MN
Other
Enumeration date
05/10/2012
Last updated
05/10/2012
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