Organization
SHAMBLOTT FAMILY DENTAL CENTER PLLC
Active
Other names
Dental Care Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (VP INSURANCE PLAN MANAGEMENT)
(727) 424-2990
Entity
Organization
Contact information
Practice address
400 SELBY AVE, SAINT PAUL, MN 55102-4508
(651) 222-6880
Mailing address
400 SELBY AVE, SAINT PAUL, MN 55102-4508
(651) 222-6880
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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