Organization
COMMUNITY DENTAL CARE INC
Active
Other names
Community Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KORI C CARLSON (HR DIRECTOR)
(651) 925-8427
Entity
Organization
Contact information
Practice address
600 CARLTON STREET N, MAPLEWOOD, MN 55119
(651) 774-2959
(651) 774-1997
Mailing address
1670 BEAM AVE, MAPLEWOOD, MN 55109
(651) 925-8400
(651) 925-8439
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
460668000
MN
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
460668000
—
MN
Enumeration date
01/26/2006
Last updated
07/24/2025
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