Organization
A GENTLE DENTAL CENTER OF ROBBINSDALE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL PUCEL KOOPMAN D.D.S. (OWNER, MANAGING MEMBER)
(763) 537-4531
Entity
Organization
Contact information
Practice address
4930 42ND AVE N, ROBBINSDALE, MN 55422-1731
(763) 537-4531
Mailing address
4930 42ND AVE N, ROBBINSDALE, MN 55422-1731
(763) 537-4531
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/16/2019
Last updated
08/16/2019
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