Organization
METROPOLITAN PEDIATRIC DENTAL ASSOCIATES, LTD
Active
Parent organization
METROPOLITAN PEDIATRIC DENTAL ASSOCIATES, LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
METROPOLITAN PEDIATRIC DENTAL ASSOCIATES, LTD
Authorized official
JAMES D NICKMAN DDS (PRESIDENT)
(651) 224-4969
Entity
Organization
Contact information
Practice address
1021 BANDANA BLVD E, SUITE 121, SAINT PAUL, MN 55108-5113
(651) 224-4969
(651) 223-8047
Mailing address
1021 BANDANA BLVD E, SUITE 121, SAINT PAUL, MN 55108-5113
(651) 224-4969
(651) 223-8047
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
518322700
—
MN
Enumeration date
01/09/2007
Last updated
05/14/2015
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