Organization
CEDAR ISLAND DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENIE KUBLE (CONTACT OFFICER)
(920) 450-0157
Entity
Organization
Contact information
Practice address
7378 KIRKWOOD CT N, MAPLE GROVE, MN 55369-5270
(763) 391-7600
Mailing address
7378 KIRKWOOD CT N, MAPLE GROVE, MN 55369-5270
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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