Organization
NORTHDALE DENTIST PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAGANNATIAN RAMAKRISHNAN B.D.S. (DENTIST)
(763) 218-2887
Entity
Organization
Contact information
Practice address
2147, NORTHDALE BLVD NW., COON RAPIDS, MN 55433
(763) 497-6977
(763) 463-7807
Mailing address
6808, 67TH STREET NE., ALBERTVILLE, MN 55301
(763) 218-2887
(763) 463-7807
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12003
MN
Other
Enumeration date
10/13/2010
Last updated
10/13/2010
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