Organization
GERALD D. CAVANAUGH & WILLIAM F. LILJEMARK
Active
Other names
Edina Orthodontic Associates
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT ROBERT BOWLBY D.D.S. (MANAGING PARTNER/ORTHODONTIST)
(952) 926-2335
Entity
Organization
Contact information
Practice address
3939 W. 50TH ST, SUITE #207, EDINA, MN 55424-1258
(952) 926-2335
(952) 925-0467
Mailing address
3939 W. 50TH ST, SUITE #207, EDINA, MN 55424-1258
(952) 926-2335
(952) 925-0467
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D11240,9023,10908AND
MN
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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