Organization
NORTHSTAR DENTAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SHAWN NANNE DDS (OWNER PRESIDENT)
(952) 892-7700
Entity
Organization
Contact information
Practice address
675 E NICOLLET BLVD, SUITE 120, BURNSVILLE, MN 55337-6741
(952) 892-7700
(952) 892-7767
Mailing address
675 E NICOLLET BLVD, SUITE 120, BURNSVILLE, MN 55337-6741
(952) 892-7700
(952) 892-7767
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10615
MN
Other
Enumeration date
05/24/2006
Last updated
08/22/2020
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