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Organization
STILLWATER MODERN DENTISTRY. PC
Active
Organization
STILLWATER MODERN DENTISTRY. PC
Active
Other names
Stillwater Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA JEAN KOEHLER (OWNER)
(651) 352-4629
Entity
Organization
Contact information
Practice address
13331 60TH ST N, OAK PARK HEIGHTS, MN 55082-1287
(651) 352-4629
(651) 359-2935
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/06/2023
Last updated
02/06/2023
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