Organization
MENDES FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES H MENDES DDS (OWNER)
(651) 699-0404
Entity
Organization
Contact information
Practice address
550 SNELLING AVE S, SAINT PAUL, MN 55116-1564
(651) 699-0404
(651) 699-9034
Mailing address
550 SNELLING AVE S, SAINT PAUL, MN 55116-1564
(651) 699-0404
(651) 699-9034
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
481641200
—
MN
05
—
728815800
—
MN
Enumeration date
04/30/2008
Last updated
04/30/2008
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