Organization
DENTAL ON FIRST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID TYCAST DDS (OWNER)
(314) 517-8885
Entity
Organization
Contact information
Practice address
136 MAIN ST W, NEW PRAGUE, MN 56071-2334
(952) 758-3003
Mailing address
136 MAIN ST W, NEW PRAGUE, MN 56071-2334
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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