Organization
GROUP HEALTH PLAN INC
Active
Other names
HealthPartners West Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN M COONEY (CAO)
(952) 883-7565
Entity
Organization
Contact information
Practice address
5100 GAMBLE DR, STE 100, ST LOUIS PARK, MN 55416-1521
(952) 593-0779
(952) 595-6451
Mailing address
8100 34TH AVE S, 21113A, BLOOMINGTON, MN 55425-1672
(952) 883-5151
(952) 883-5160
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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