Organization
FAMILY ORTHODONTIC SPECIALISTS PLC
Active
Parent organization
FAMILY ORTHODONTIC SPECIALISTS PLC
Other names
Woodlake Orthodontics St Louis Park
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY ORTHODONTIC SPECIALISTS PLC
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
4959 EXCELSIOR BLVD STE 200, ST LOUIS PARK, MN 55416-3003
(952) 920-8774
(952) 920-8979
Mailing address
4959 EXCELSIOR BLVD STE 200, ST LOUIS PARK, MN 55416-3003
(952) 920-8774
(952) 920-8979
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
04/20/2022
Last updated
04/20/2022
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