Organization
GROUP HEALTH PLAN INC
Active
Other names
HealthPartners White Bear Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN M COONEY (CAO)
(952) 883-7565
Entity
Organization
Contact information
Practice address
1430 HIGHWAY 96 E, WHITE BEAR LAKE, MN 55110-3653
(651) 426-9502
(651) 653-2158
Mailing address
8100 34TH AVE S, 21113A, BLOOMINGTON, MN 55425-1672
(952) 883-5151
(952) 883-5160
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/24/2007
Last updated
08/22/2020
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