Organization
FOUNDATIONS PSA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE MINER DDS (OWNER)
(952) 955-4300
Entity
Organization
Contact information
Practice address
126 PIONEER TRL, CHASKA, MN 55318-1167
(952) 472-7738
Mailing address
1635 SUNNYBROOK CIR, MINNETRISTA, MN 55364-1276
(612) 387-5009
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
08/25/2023
Last updated
05/11/2026
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