Organization
STILLWATER DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HASSAN ISMAIL (OWNER)
(651) 321-1007
Entity
Organization
Contact information
Practice address
1963 ROBERT ST S STE 100, WEST ST PAUL, MN 55118-3942
(651) 321-1007
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/28/2017
Last updated
09/28/2017
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