Organization
EDINA 5-O DENTAL PA
Active
Parent organization
EDINA 5-O DENTAL PA
Other names
Drew F Spencer DDS
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDINA 5-O DENTAL PA
Authorized official
DR. DREW F SPENCER DDS (DENTIST OWNER)
(952) 922-8111
Entity
Organization
Contact information
Practice address
3948 W 50TH ST, SUITE 205, EDINA, MN 55424
(952) 922-8111
(952) 922-2125
Mailing address
3948 W 50TH ST, SUITE 205, EDINA, MN 55424
(952) 922-8111
(952) 922-2125
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10569
MN
1223G0001X
General Practice Dentistry
10569
MN
Other
Enumeration date
11/22/2006
Last updated
07/08/2008
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