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Organization
FAMILY & COSMETIC GENTLE DENTISTRY, LTD.
Active
Organization
FAMILY & COSMETIC GENTLE DENTISTRY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT LUTHER BODIN DDS (PRESIDENT)
(952) 224-9771
Entity
Organization
Contact information
Practice address
5100 EDEN AVE STE 209, EDINA, MN 55436-2338
(952) 929-0641
Mailing address
6600 FRANCE AVE S STE 415, EDINA, MN 55435-1817
(952) 224-9771
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0700X
Prosthodontics
—
—
Other
Enumeration date
10/06/2005
Last updated
10/28/2009
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