Organization
DENTAL SPECIALISTS OF MINNESOTA, PLLC
Active
Other names
The Dental Specialist Minnetonka
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON HESSE (CREDENTIALING SPECIALISTS)
(651) 746-2815
Entity
Organization
Contact information
Practice address
14525 HIGHWAY 7 STE 125, MINNETONKA, MN 55345-3738
(952) 303-8858
(952) 314-4892
Mailing address
2200 COUNTY ROAD C W STE 2210, ROSEVILLE, MN 55113-2551
(651) 746-2815
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
06/13/2020
Last updated
06/13/2020
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