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Organization
DENTALIGN P.A.
Active
Organization
DENTALIGN P.A.
Active
Other names
TC Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HOLLY KELLY DMD (PRESIDENT/OWNER)
(763) 420-1030
Entity
Organization
Contact information
Practice address
15875 EMPEROR AVENUE, APPLE VALLEY, MN 55124
(651) 344-8817
Mailing address
4630 EDGEBROOK PLACE, EDINA, MN 55424
(763) 420-1030
(763) 420-5510
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
11493
MN
Other
Enumeration date
01/18/2018
Last updated
01/18/2018
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