Organization
FAMILY PERIODONTIC SPECIALISTS, PLC
Active
Parent organization
FAMILY PERIODONTIC SPECIALISTS, PLC
Other names
Metro Dentalcare Specialty Center Burnsville - Periodontics
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY PERIODONTIC SPECIALISTS, PLC
Authorized official
CELIA HAYES (CREDENTIALING COORDINATOR)
(217) 540-2100
Entity
Organization
Contact information
Practice address
14344 BURNHAVEN DR, BURNSVILLE, MN 55306-4928
(612) 638-1238
(952) 898-4109
Mailing address
14344 BURNHAVEN DR, BURNSVILLE, MN 55306-4928
(612) 638-1238
(952) 898-4109
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
03/22/2022
Last updated
03/22/2022
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