Organization
ON-SITE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN CHARLES FINCHAM (EXECUTIVE DIRECTOR)
(612) 961-0866
Entity
Organization
Contact information
Practice address
7600 FRANCE AVE. S., SUITE 1100, EDINA, MN 55130-5924
(763) 545-7545
(952) 929-2067
Mailing address
7600 FRANCE AVE. S., SUITE 1100, EDINA, MN 55436-5924
(763) 545-7545
(952) 929-2067
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
MN
Other
Enumeration date
12/20/2016
Last updated
11/15/2017
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