Organization
BLAINE KIDDS PEDIATRIC DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARCY J RINDELAUB DDS, MS (OWNER)
(651) 324-4270
Entity
Organization
Contact information
Practice address
1351 113TH AVE NE, BLAINE, MN 55434-3874
(651) 324-4270
Mailing address
400 2ND ST S STE 250, HUDSON, WI 54016-1599
(715) 808-0460
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D11365
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122648700
—
MN
01
—
1639126683
PROVIDER NPI
—
Enumeration date
09/27/2017
Last updated
09/27/2017
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