Organization
ADVANCE FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOLLY SEIDL (OFFICE MANAGER)
(651) 482-1122
Entity
Organization
Contact information
Practice address
925 COUNTY ROAD E E, SUITE 185, VADNAIS HEIGHTS, MN 55127-7179
(651) 482-1122
(651) 766-2557
Mailing address
925 COUNTY ROAD E E, SUITE 185, VADNAIS HEIGHTS, MN 55127-7179
(651) 482-1122
(651) 766-2557
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
12387
MN
261QD0000X
Dental Clinic/Center
Primary
9142
MN
Other
Enumeration date
11/06/2007
Last updated
11/06/2007
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