Organization
STAT DENTAL, INC
Active
Other names
Emergency Dental Care USA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY J GIBLETTE (PRESIDENT)
(612) 859-7359
Entity
Organization
Contact information
Practice address
2233 HAMLINE AVE N, SUITE 432, ROSEVILLE, MN 55113-5009
(651) 778-9911
(651) 633-0146
Mailing address
15043 BRIDGEWATER DR, SAVAGE, MN 55378-5618
(612) 859-7359
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/11/2007
Last updated
08/22/2020
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