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Individual

DR. AMELIA MIKKONEN GERLACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
6437 BROOKLYN BLVD, BROOKLYN CENTER, MN 55429-2174
(763) 531-7177
(763) 535-6284
Mailing address
5809 91ST CRES N, BROOKLYN PARK, MN 55443-1620
(763) 424-7292

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11653
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1643800
MN
Enumeration date
12/08/2006
Last updated
07/08/2007
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