Individual
MAX ADDERSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
636 BROADWAY ST NE, MINNEAPOLIS, MN 55413
(515) 770-8529
Mailing address
636 BROADWAY ST NE, MINNEAPOLIS, MN 55413
(515) 770-8529
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DDS-09781
IA
1223G0001X
General Practice Dentistry
Primary
1265059240
MN
1223G0001X
General Practice Dentistry
D14523
MN
Other
Enumeration date
06/25/2020
Last updated
01/18/2024
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