Organization
GROVE ENDODONTICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS W WALDRON D.D.S. (PRESIDENT)
(651) 768-8180
Entity
Organization
Contact information
Practice address
8811 92ND ST S, SUITE 109, COTTAGE GROVE, MN 55016-4036
(651) 768-8180
(651) 768-8184
Mailing address
8811 92ND ST S, SUITE 109, COTTAGE GROVE, MN 55016-4036
(651) 768-8180
(651) 768-8184
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D10981
MN
Other
Enumeration date
11/21/2006
Last updated
08/22/2020
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