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Individual

DR. GREGORY SCOTT LATUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1670 BEAM AVE STE 204, MAPLEWOOD, MN 55109-1227
(651) 925-8400
(651) 773-7568
Mailing address
6721 MADISON ST NE, FRIDLEY, MN 55432-4450
(414) 588-7096

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
30.023696
OH
122300000X
Dentist
Primary
D14641
MN

Other

Enumeration date
05/31/2012
Last updated
12/22/2021
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