Organization
IVORY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLE P BRENNY DDS (OWNER)
(612) 338-8636
Entity
Organization
Contact information
Practice address
825 NICOLLET MALL STE 505, MINNEAPOLIS, MN 55402-2607
(612) 338-8636
Mailing address
825 NICOLLET MALL STE 505, MINNEAPOLIS, MN 55402-2607
(612) 338-8636
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12802
MN
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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