Organization
MINNESOTA DENTAL PROFESSIONALS, P.C.
Active
Parent organization
HEARTLAND DENTAL
Other names
Blue Heron Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEARTLAND DENTAL
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
601 APOLLO DR STE 110, LINO LAKES, MN 55014-3020
(763) 542-3765
Mailing address
601 APOLLO DR STE 110, LINO LAKES, MN 55014-3020
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/13/2024
Last updated
07/24/2024
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