Organization
MIRACLE MILE DENTISTRY PA
Active
Other names
36th Street Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN MICHAEL DUNLAVEY DDS (PRESIDENT)
(612) 799-7525
Entity
Organization
Contact information
Practice address
5806A W 36TH ST, ST LOUIS PARK, MN 55416-5108
(952) 929-5292
Mailing address
5806A W 36TH ST, ST LOUIS PARK, MN 55416-5108
(952) 929-5292
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
MN
Other
Enumeration date
03/13/2015
Last updated
03/13/2015
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