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Organization
PLYMOUTH PLAZA DENTAL
Active
Organization
PLYMOUTH PLAZA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET ANN NIELSEN (OFFICE MANAGER)
(763) 476-6774
Entity
Organization
Contact information
Practice address
1495 COUNTY ROAD 101 N, SUITE2, PLYMOUTH, MN 55447-3078
(763) 476-6774
(763) 476-2147
Mailing address
1495 COUNTY ROAD 101 N, SUITE2, PLYMOUTH, MN 55447-3078
(763) 476-6774
(763) 476-2147
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8320
MN
Other
Enumeration date
04/24/2007
Last updated
08/22/2020
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