Organization
MAPLE GROVE CENTER FOR RESTORATIVE SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL HANSON (MEDICAL DIRECTOR)
(651) 324-8693
Entity
Organization
Contact information
Practice address
13601 80TH CIRCLE NORTH, SUITE 100, MAPLE GROVE, MN 55369
(763) 432-7655
(763) 432-7501
Mailing address
13601 80TH CIRCLE NORTH, SUITE 100, MAPLE GROVE, MN 55369
(763) 432-7655
(763) 432-7501
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2019
Last updated
10/28/2020
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