Individual
MILDRED COLLAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1790 7TH ST E, SAINT PAUL, MN 55119-3419
(651) 735-0595
Mailing address
351 LABORE RD, #320, LITTLE CANADA, MN 55117-1156
(561) 294-4796
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12955
MN
Other
Enumeration date
06/22/2011
Last updated
06/22/2011
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