Organization
3RD STREET DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ISRAEL DDS (DENTIST)
(646) 710-0666
Entity
Organization
Contact information
Practice address
212 3RD ST STE 5, TRACY, MN 56175-1267
(507) 626-8826
Mailing address
3RD STREET DENTAL LLC, PO BOX 1153, TRACY, MN 56175
(646) 710-0666
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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