Organization
CAMPODONICO FAMILY & COSMETIC DENTISTRY PC
Active
Other names
Arden Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS ERNESTO CAMPODONICO DDS (OWNER)
(763) 786-1545
Entity
Organization
Contact information
Practice address
11806 ABERDEEN ST NE, SUITE 150, BLAINE, MN 55449-4736
(763) 786-1545
(763) 786-2939
Mailing address
11806 ABERDEEN ST NE, SUITE 150, BLAINE, MN 55449-4736
(763) 786-1545
(763) 786-2939
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154546877
NPI
MN
Enumeration date
01/27/2014
Last updated
01/27/2014
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