Organization
FOUR SEASONS DENTAL PA
Active
Other names
Four Seasons Dental PA
Organization subpart
No
Provider details
NPI number
Authorized official
KERSTEN HOFFMAN (CLINIC ADMINISTRATOR)
(952) 475-0225
Entity
Organization
Contact information
Practice address
4205 LANCASTER LN N STE 101, PLYMOUTH, MN 55441-1702
(763) 559-2976
(763) 559-4852
Mailing address
109 BUSHAWAY RD STE 300, WAYZATA, MN 55391-2079
(952) 475-0225
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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