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Organization
BLISS FAMILY DENTAL JULIE KONOP, DDS, PLLC
Active
Organization
BLISS FAMILY DENTAL JULIE KONOP, DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE KONOP DDS (SOLE PROPRIETOR/OWNER)
(952) 447-3777
Entity
Organization
Contact information
Practice address
4792 DAKOTA ST SE, PRIOR LAKE, MN 55372-1883
(952) 447-3777
(952) 447-2877
Mailing address
4792 DAKOTA ST SE, PRIOR LAKE, MN 55372-1883
(952) 447-3777
(952) 447-2877
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700993284
TYPE 1
MN
Enumeration date
04/13/2022
Last updated
04/13/2022
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