Organization
ECKART DENTAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA M. KREUSER (OFFICE MANAGER)
(952) 445-1352
Entity
Organization
Contact information
Practice address
300 1ST AVE E, SHAKOPEE, MN 55379-1444
(952) 445-1352
(952) 445-7221
Mailing address
300 1ST AVE E, SHAKOPEE, MN 55379-1444
(952) 445-1352
(952) 445-7221
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9527
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03905EC
BCBS #
MN
01
—
4040598
MEDICA
MN
Enumeration date
08/25/2006
Last updated
08/22/2020
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