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Organization

FIRST AVENUE DENTAL PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ZACHARY STEVEN CONKLIN DDS (OWNER)
(320) 241-6927
Entity
Organization

Contact information

Practice address
74 1ST AVE SE, LITTLE FALLS, MN 56345-3042
(320) 241-6927
Mailing address
720 ROBERTS RD APT 310, SARTELL, MN 56377-3403
(320) 241-6927

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
05/25/2023
Last updated
05/25/2023
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