Organization
MAPLEWOOD DENTAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD J PROKOSCH DDS (PRESIDENT)
(651) 770-6900
Entity
Organization
Contact information
Practice address
1736 EAST COPE AVE, MAPLEWOOD, MN 55109-2610
(651) 770-3831
(651) 770-9645
Mailing address
1736 EAST COPE AVE, MAPLEWOOD, MN 55109-2610
(651) 770-3831
(651) 770-9645
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/10/2006
Last updated
08/22/2020
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