Individual
MILES KNUTSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
Mailing address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14959
MN
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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