Organization
SMILES FOR LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN GROSS DDS (DENTIST)
(612) 309-9713
Entity
Organization
Contact information
Practice address
5009 EXCELSIOR BLVD STE 124, SAINT LOUIS PARK, MN 55416-3040
(952) 926-0020
Mailing address
5009 EXCELSIOR BLVD STE 124, SAINT LOUIS PARK, MN 55416-3040
(952) 926-0020
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/31/2021
Last updated
09/01/2021
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