Individual
MARY OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
14418 EXCELSIOR BLVD, MINNETONKA, MN 55345-5820
(952) 935-5212
Mailing address
14418 EXCELSIOR BLVD, MINNETONKA, MN 55345-5820
(952) 935-5212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10075
MN
Other
Enumeration date
01/23/2006
Last updated
04/06/2015
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