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Organization

CAROUSEL PEDIATRIC DENTISTRY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KYLE NORDEEN DDS (OWNER)
(952) 715-6177
Entity
Organization

Contact information

Practice address
15160 FOLIAGE AVE STE 110, APPLE VALLEY, MN 55124-5916
(952) 715-6177
Mailing address
15160 FOLIAGE AVE STE 110, APPLE VALLEY, MN 55124-5916
(952) 715-6177

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry

Other

Enumeration date
12/23/2020
Last updated
12/23/2020
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