Organization
RICHFIELD PEDIATRIC DENTISTRY, P.A.
Active
Parent organization
TAYLOR J. STEPHENS, D.D.S, P.A
Other names
Tailwind Pediatric Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
TAYLOR J. STEPHENS, D.D.S, P.A
Authorized official
TAYLOR J STEPHENS D.D.S. (PRESIDENT/OWNER)
(952) 475-3135
Entity
Organization
Contact information
Practice address
6945 PENN AVE S, SUITE 102, RICHFIELD, MN 55423-2081
(612) 866-4041
Mailing address
250 CENTRAL AVE N, SUITE 113, WAYZATA, MN 55391-1206
(952) 475-3135
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D12818
MN
Other
Enumeration date
02/21/2013
Last updated
01/14/2014
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