Organization
ADT DENTAL, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN ZECCO (CLINIC ADMINISTRATOR)
(612) 377-6108
Entity
Organization
Contact information
Practice address
2232 HENNEPIN AVE, MINNEAPOLIS, MN 55405-2737
(612) 377-6108
(612) 374-1820
Mailing address
2232 HENNEPIN AVE, MINNEAPOLIS, MN 55405-2737
(612) 377-6108
(612) 374-1820
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013454
DORAL DENTAL
MN
01
—
1727
HEALTH PARTNERS
MN
01
—
46092 DE
BLUE CROSS BLUE SHIELD
MN
01
—
978483
UNITED CONCORDIA
MN
Enumeration date
07/25/2006
Last updated
08/22/2020
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