Organization
CENTRAL MINNESOTA ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LYNN LANGSJOEN (TREASURER)
(320) 255-1111
Entity
Organization
Contact information
Practice address
1500 NORTHWAY DR, SAINT CLOUD, MN 56303-4477
(320) 529-4889
Mailing address
1500 NORTHWAY DR, SAINT CLOUD, MN 56303-4477
(320) 529-4889
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
11705
MN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
8228
MN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
S-9
MN
Other
Enumeration date
12/26/2006
Last updated
08/22/2020
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