Organization
ISLES DENTAL ASSOCIATES P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWN MARIE MILLER CDA-RDA (ADMINISTRATOR)
(612) 374-4321
Entity
Organization
Contact information
Practice address
2534 HENNEPIN AVE, MINNEAPOLIS, MN 55405-3548
(612) 374-4321
(612) 381-8518
Mailing address
2534 HENNEPIN AVE, MINNEAPOLIS, MN 55405-3548
(612) 374-4321
(612) 381-8518
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10995
MI
1223G0001X
General Practice Dentistry
M11654
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669547477
NPI NUMBER
MN
01
—
1780655753
NPI NUMBER
MN
Enumeration date
08/06/2008
Last updated
08/06/2008
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