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Organization
NICOLLET FAMILY DENTISTRY
Active
Organization
NICOLLET FAMILY DENTISTRY
Active
Other names
Dentures ASAP South
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACEY ROSEANN CHARLES DDS (DOCTOR/OWNER)
(612) 870-4646
Entity
Organization
Contact information
Practice address
2738 WINNETKA AVE N STE 100, NEW HOPE, MN 55427-2877
(612) 870-4646
Mailing address
2738 WINNETKA AVE N STE 100, NEW HOPE, MN 55427-2877
(612) 870-4646
(763) 717-8491
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
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