Organization
WOODDALE DENTAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMES SPENCER (PRESIDENT)
(952) 929-3336
Entity
Organization
Contact information
Practice address
3401 WOODDALE AVE S, ST LOUIS PARK, MN 55416-2340
(952) 929-3336
(952) 929-3338
Mailing address
3401 WOODDALE AVE S, ST LOUIS PARK, MN 55416-2340
(952) 929-3336
(952) 929-3338
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/18/2006
Last updated
08/22/2020
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