Organization
SEDATION & IMPLANT DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARL ANDREW ANDRESON DDS (OWNER)
(651) 735-4661
Entity
Organization
Contact information
Practice address
1815 SUBURBAN AVE, SAINT PAUL, MN 55119-4302
(651) 735-4661
(651) 735-1910
Mailing address
1815 SUBURBAN AVE, SAINT PAUL, MN 55119-4302
(651) 735-4661
(651) 735-1910
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D7091
MN
1223G0001X
General Practice Dentistry
D9766
MN
1223P0300X
Periodontics
D12228
MN
1223P0300X
Periodontics
Primary
D9208
MN
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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