Individual
CLAIRE O MIELKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
636 BROADWAY ST NE, MINNEAPOLIS, MN 55413-2164
(612) 746-1530
Mailing address
636 BROADWAY ST NE, MINNEAPOLIS, MN 55413-2164
(612) 746-1530
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12581
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
321818000
—
MN
Enumeration date
06/16/2008
Last updated
06/16/2008
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