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Organization

THE DENTAL SPECIALIST OF MINNESOTA, PLLC

Active
Other names
The Dental Specialist St Croix Valley
Organization subpart
No

Provider details

NPI number
Authorized official
SHANNON HESSE (CREDENTIALING SPECIALIST)
(651) 746-2815
Entity
Organization

Contact information

Practice address
13961 60TH ST N, STILLWATER, MN 55082-1053
(651) 760-3681
(651) 760-3683
Mailing address
2200 COUNTY ROAD C W STE 2210, ROSEVILLE, MN 55113-2551

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Enumeration date
05/01/2019
Last updated
10/28/2020
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