Organization
G2 SOUTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY MICHELLE KOCH (PRACTICE DIRECTOR)
(651) 464-2248
Entity
Organization
Contact information
Practice address
5846 BLACKSHIRE PATH, INVER GROVE HEIGHTS, MN 55076
(651) 389-1133
(651) 464-1135
Mailing address
5846 BLACKSHIRE PATH, INVER GROVE HEIGHTS, MN 55076
(651) 389-1133
(651) 389-1135
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
MN
Other
Enumeration date
08/30/2006
Last updated
08/13/2008
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