Organization
JAIN DENTAL ST. LOUIS PARK, PLLC
Active
Parent organization
TROWBRIDGE ENTERPRISES, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TROWBRIDGE ENTERPRISES, PLLC
Authorized official
DR. NICHOLAS BUSSA (GENERAL DENTIST)
(952) 926-3392
Entity
Organization
Contact information
Practice address
4600 EXCELSIOR BLVD, ST LOUIS PARK, MN 55416-4938
(952) 926-3392
Mailing address
4600 EXCELSIOR BLVD, ST LOUIS PARK, MN 55416-4938
(952) 926-3392
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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