Organization
FAMILY ORTHODONTIC SPECIALISTS PLC
Active
Parent organization
FAMILY ORTHODONTIC SPECIALISTS PLC
Other names
Woodlake Orthodontics Midway - St. Paul
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
1375 SAINT ANTHONY AVE, SAINT PAUL, MN 55104-4006
(651) 286-8153
Mailing address
1375 SAINT ANTHONY AVE, SAINT PAUL, MN 55104-4006
(651) 286-8153
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/20/2022
Last updated
04/20/2022
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