Organization
DAKOTA CHILDREN'S DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL H GLENN D.D.S, M.S. (PRESIDENT)
(651) 322-5788
Entity
Organization
Contact information
Practice address
3410 151ST ST W, ROSEMOUNT, MN 55068-1755
(651) 322-5788
(651) 322-4257
Mailing address
3410 151ST ST W, ROSEMOUNT, MN 55068-1755
(651) 322-5788
(651) 322-4257
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D10462
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3049280
—
MN
Enumeration date
11/02/2006
Last updated
08/22/2020
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