Organization
SYDLEWSKI ORTHODONTICS
Active
Organization
SYDLEWSKI ORTHODONTICS
Active
Other names
Signature Orthodontics, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH REID RAASCH (FINANCIAL COODINATOR)
(651) 426-9986
Entity
Organization
Contact information
Practice address
1575 7TH ST W STE 102, SAINT PAUL, MN 55102-4252
(651) 426-9986
Mailing address
2126 5TH ST, WHITE BEAR LAKE, MN 55110-2717
(651) 426-9986
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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