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Organization
TANGLETOWN DENTAL LLC
Active
Organization
TANGLETOWN DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAN A NIELSEN (OFFICE MANAGER)
(612) 822-2324
Entity
Organization
Contact information
Practice address
4831 NICOLLET AVE, MINNEAPOLIS, MN 55419-5534
(612) 822-2324
(612) 822-6763
Mailing address
4831 NICOLLET AVE, MINNEAPOLIS, MN 55419-5534
(612) 822-2324
(612) 822-6763
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8320
MN
Other
Enumeration date
06/25/2014
Last updated
06/25/2014
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