Organization
HEALTHY TEETH CLUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REBECCA LYNNE FAHNING RDH,BS (DENTAL HYGIENIST)
(651) 894-4391
Entity
Organization
Contact information
Practice address
13410 CANALVILLE LANE, GRASSTON, MN 55030-2162
(651) 894-4391
Mailing address
13410 CANALVILLE LANE, GRASSTON, MN 55030-2162
(651) 894-4391
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
12/08/2009
Last updated
12/08/2009
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