Organization
PETER H MIELKE DDS PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER HERMANN MIELKE DDS (PEDODONTIST)
(651) 779-9002
Entity
Organization
Contact information
Practice address
1675 BEAM AVE STE 202, MAPLEWOOD, MN 55109-1479
(651) 779-9002
Mailing address
1675 BEAM AVE STE 202, MAPLEWOOD, MN 55109-1479
(651) 779-9002
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
MN
Other
Enumeration date
03/17/2008
Last updated
06/23/2008
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