Organization
NORTHEAST DENTAL, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT L KEIFER D.D.S. (PRESIDENT)
(651) 426-4799
Entity
Organization
Contact information
Practice address
4520 CENTERVILLE RD, SAINT PAUL, MN 55127-3602
(651) 426-4799
(651) 426-8106
Mailing address
4520 CENTERVILLE RD, SAINT PAUL, MN 55127-3602
(651) 426-4799
(651) 426-8106
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7820
MN
Other
Enumeration date
04/16/2007
Last updated
08/22/2020
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