Individual
DR. STACEY KAY WOLKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
18315 CASCADE DR, SUITE 120, EDEN PRAIRIE, MN 55347-1180
(952) 949-2536
(952) 949-3942
Mailing address
7216 GUNFLINT TRL, CHANHASSEN, MN 55317-7576
(612) 708-3547
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12250
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298483100
—
MN
Enumeration date
12/08/2006
Last updated
08/16/2016
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