Organization
UNIVERSITY AVE DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY SPANISH DDS (OWNER)
(952) 836-7924
Entity
Organization
Contact information
Practice address
10155 UNIVERSITY AVE NE STE 112, BLAINE, MN 55434-8058
(763) 784-1242
Mailing address
10155 UNIVERSITY AVE NE STE 112, BLAINE, MN 55434-8058
(763) 784-1242
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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