Organization
PLAZA DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOAN A SHEPPARD (OWNER OFFICER)
(952) 890-5450
Entity
Organization
Contact information
Practice address
1601 E HWY 13, SUITE 105, BURNSVILLE, MN 55337
(952) 890-5450
(952) 707-1122
Mailing address
1601 E HWY 13, SUITE 105, BURNSVILLE, MN 55337
(952) 890-5450
(952) 707-1122
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D11218
MN
122300000X
Dentist
D7323
MN
122300000X
Dentist
Primary
D8868
MN
Other
Enumeration date
07/01/2006
Last updated
08/22/2020
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