Organization
GROUP HEALTH PLAN INC
Active
Other names
HealthPartners Specialty Dental
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BJORKMAN (DIRECTOR PROVIDER ENROLLMENT)
(952) 883-7469
Entity
Organization
Contact information
Practice address
2500 COMO AVE, SAINT PAUL, MN 55108-1460
(651) 647-2500
Mailing address
8170 33RD AVE S, BLOOMINGTON, MN 55425-4516
(952) 883-5155
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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