Organization
MIDWEST ENDODONTICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM A. GAVIN D.D.S. (PREIDENT)
(651) 731-1630
Entity
Organization
Contact information
Practice address
6949 VALLEY CREEK RD, #130, WOODBURY, MN 55125-2253
(651) 731-1630
(651) 731-1635
Mailing address
6949 VALLEY CREEK RD, #130, WOODBURY, MN 55125
(651) 731-1630
(651) 731-1635
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
7305
MN
Other
Enumeration date
04/03/2007
Last updated
08/22/2020
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