Organization
GROUP HEALTH PLAN INC
Active
Other names
HealthPartners Coon Rapids Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN M COONEY (CAO)
(952) 883-7565
Entity
Organization
Contact information
Practice address
11475 ROBINSON DR NW, COON RAPIDS, MN 55433-3746
(763) 754-0041
(763) 754-4506
Mailing address
8100 34TH AVE S, 21113A, BLOOMINGTON, MN 55425-1672
(952) 883-5151
(952) 883-5160
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5177171-00
—
MN
Enumeration date
01/24/2007
Last updated
07/18/2008
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