Organization
ON-SITE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN FINCHAM (EXECUTIVE DIRECTOR)
(763) 545-7545
Entity
Organization
Contact information
Practice address
7600 FRANCE AVE S STE 1100, EDINA, MN 55435-5936
(763) 545-7545
(952) 929-2067
Mailing address
7600 FRANCE AVE S STE 1100, EDINA, MN 55435-5936
(763) 545-7545
(952) 929-2067
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
213E00000X
Podiatrist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/17/2018
Last updated
05/17/2018
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