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Organization

BLISS FAMILY DENTAL JULIE KONOP, DDS, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JULIE KONOP DDS (SOLE PROPRIETOR/OWNER)
(952) 447-3777
Entity
Organization

Contact information

Practice address
4792 DAKOTA ST SE, PRIOR LAKE, MN 55372-1883
(952) 447-3777
(952) 447-2877
Mailing address
4792 DAKOTA ST SE, PRIOR LAKE, MN 55372-1883
(952) 447-3777
(952) 447-2877

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1700993284
TYPE 1
MN
Enumeration date
04/13/2022
Last updated
04/13/2022
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