Organization
CLD - COON RAPIDS MN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID PARK DMD (CEO/OWNER)
(651) 444-9644
Entity
Organization
Contact information
Practice address
3790 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2629
(763) 200-5280
Mailing address
3790 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2629
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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