Organization
DENTALIGN, PA
Active
Organization
DENTALIGN, PA
Active
Other names
TC Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD KELLY DMD (PRESIDENT)
(763) 420-1030
Entity
Organization
Contact information
Practice address
11942 BUSINESS PARK BLVD, CHAMPLIN, MN 55316
(763) 421-9131
Mailing address
4630 EDGEBROOK PLACE, EDINA, MN 55424
(612) 701-0478
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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