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Organization
NORTHERN ORTHODONTICS
Active
Organization
NORTHERN ORTHODONTICS
Active
Parent organization
ST. CROIX VALLEY DENTAL, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. CROIX VALLEY DENTAL, PLLC
Authorized official
DR. DOUG S WOLFF D.D.S. (OWNER)
(651) 439-2600
Entity
Organization
Contact information
Practice address
1109 EAST MOORE LAKE DRIVE, FRIDLEY, MN 55432
(651) 439-2600
(651) 439-2211
Mailing address
1109 EAST MOORE LAKE DRIVE, FRIDLEY, MN 55432
(651) 439-2600
(651) 439-2211
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D111236
MN
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/21/2011
Last updated
03/21/2011
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