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Organization
GRAND DENTAL CARE, PLLC
Active
Organization
GRAND DENTAL CARE, PLLC
Active
Other names
Grand Avenue Dental, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SCOTT TYLER (BUSINESS MANAGER)
(651) 291-9667
Entity
Organization
Contact information
Practice address
960 GRAND AVE, SAINT PAUL, MN 55105-3014
(651) 291-9667
Mailing address
960 GRAND AVE, SAINT PAUL, MN 55105-3014
(651) 291-9667
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/16/2021
Last updated
02/16/2021
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