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Organization
WAYZATA DENTAL, LTD.
Active
Organization
WAYZATA DENTAL, LTD.
Active
Other names
Wayzata Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON T MCDOWELL D.D.S. (OWNER)
(952) 473-4900
Entity
Organization
Contact information
Practice address
250 CENTRAL AVE N, SUITE 202, WAYZATA, MN 55391-1206
(952) 473-4900
(952) 473-4672
Mailing address
250 CENTRAL AVE N, SUITE 202, WAYZATA, MN 55391-1206
(952) 473-4900
(952) 473-4672
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/13/2007
Last updated
12/13/2007
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