Organization
COMO PARK DENTISTRY PA
Active
Other names
Como Park Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DERRIK HARTMAN DDS (PRESIDENT)
(507) 272-5955
Entity
Organization
Contact information
Practice address
1132 LARPENTEUR AVE W, SAINT PAUL, MN 55113-6317
(507) 272-5955
Mailing address
1132 LARPENTEUR AVE W, SAINT PAUL, MN 55113-6317
(507) 272-5955
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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