Organization
MINNESOTA DENTAL IMPLANT CENTER
Active
Other names
The Dental Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA MOODY (OFFICE MANAGER)
(605) 716-5622
Entity
Organization
Contact information
Practice address
8325 WAYZATA BLVD STE 150, GOLDEN VALLEY, MN 55426-1398
(763) 417-9975
(763) 417-9976
Mailing address
8325 WAYZATA BLVD STE 150, GOLDEN VALLEY, MN 55426-1398
(763) 417-9975
(763) 417-9976
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D12070
MN
122300000X
Dentist
Primary
D8779
MN
Other
Enumeration date
02/22/2012
Last updated
02/22/2012
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