Organization
MAIZE LLC
Active
Other names
Bluejay Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXIS SIMONSON DDS (OWNER)
(612) 735-4818
Entity
Organization
Contact information
Practice address
1975 11TH AVE E, MAPLEWOOD, MN 55109-5148
(651) 770-2900
Mailing address
2860 105TH AVE NE, BLAINE, MN 55449-5212
(612) 735-4818
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2017
Last updated
12/17/2017
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