Organization
DENTALIGN, PA
Active
Organization
DENTALIGN, PA
Active
Other names
TC Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD HOLLY KELLY (PRESIDENT)
(612) 701-0478
Entity
Organization
Contact information
Practice address
2999 COUNTY ROAD 42 W SUITE 138, BURNSVILLE, MN 55306
(952) 892-3282
Mailing address
4630 EDGEBROOK PLACE, EDINA, MN 55424
(612) 701-0478
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
11493
MN
Other
Enumeration date
01/03/2013
Last updated
10/13/2020
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